This study was done to determine the value of thallium-201 stress myocardial perfusion scanning for identifying disease in the individual coronary arteries. Segement analysis of rest and stress myocardial perfusion scanning was performed in 65 subjects who underwent coronary arteriography. Anterolateral wall detects had a sensitivity of 70%, a spectivity of 92%, and a predicitive accuracy of 93.3% for identifying left anterior descending(LAD) coronary artery disease(CAD). Anteroseptal wall defects had a sensitivy of 62.5%, a specificity of 80%, and a predictive accuracy of 83.3% for identifying LAD CAD. Septal wall defects had a sensitivity of 67.5%, a specificity of 92%, and a predictive accuracy of 94.4% for identifying LAD CAD. Inferior wall defects had a sensitivity of 65.4%, a specificity of 89.7%, and a predictive accuracy of 80.9% for identifying right CAD. Posterolateral wall defects had a identifying left circumflex CAD. Thus, although senmental analysis of stress myocardial perfusin scanning can identify LAD CAD with high sensitivity and specificity, only moderate sensitivity and specificity are achieved in identifying right CAD or left circumflex CAD. But stress myocardial perfusion scanning has tendency to identify the most severely ischemic area, use of segmental analysis may be of benefit in the evaluation of patients with ischemic heart disease before or after coronary artery bypass graft and percutaneous transluminal coronary angioplasty.
Angiography ; Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Myocardial Ischemia ; Perfusion* ; Sensitivity and Specificity ; Transplants

No abstract available.
Hemorrhage* ; Humans ; Infant* ; Infant, Very Low Birth Weight*

PURPOSE: We wanted to evaluate the short term clinical and radiological results and the complications of primary total hip arthroplasty with using a Accolade TMZF femoral stem. MATERIALS AND METHODS: 66 cases among 80 cases underwent total hip arthroplasty by one surgeon with using an Accolade TMZF femur stem from January 2002 to August 2006. The minimum follow-up was 30 months and we retrospectively analyzed these 66 patients. RESULTS: The mean Harris Hip Score improved from 54 to 92 at the last follow up. On the last follow-up X-ray, all the femoral stems (100%) showed stable fixation and there was no osteolysis or loosening, but there were 34 cases of stress shields and 20 cases of cortical hypertrophy. The acetabular component revealed stable fixation in 65 cases (98.5%) and loosening in one case (1.5%). There was no acetabular osteolysis, but 22 cases of radiolucency were observed in the Dee Lee and Charnley zone II. As complications, there were 5 cases of heterotrophic ossification, 1 case of greater trochanteric bursitis, 2 cases of thigh pain and 1 case with a squeaking sound. CONCLUSION: Primary total hip arthroplasty using a cementless Accolade TMZF femoral stem showed good results in the short term, but long term follow up is needed.
Arthroplasty ; Bursitis ; Femur ; Follow-Up Studies ; Hip ; Hypertrophy ; Osteolysis ; Retrospective Studies ; Thigh

In general, Orthodontists make problem lists and treatment plans based on norms of several cephalometric standards. But consideration of dentoalveolar compensation, which tends to maintain normal dental arch relationship in various skeletal jaw relationships, helps orthodontists make more individualized treatment objectives and plans. The purpose of this study was to classify skeletal pattern of normal occlusion samples by cluster analysis and to investigate the dentoalveolar compensation according to skeletal patterns. The subjects were consisted of 125 subjects who were normal occlusion samples at Seoul National University Dental Hospital, Department of Orthodontics. Lateral cephalograms in centric occlusion were traced and digitized. The skeletal patterns of normal occlusion samples were classified into three horizontal groups and three vertical groups by cluster analysis and ANOVA on the skeletal and dentoalveolar measurements among the groups were carried out. The results were as follows; 1. Anteroposterior and vertical skeletal relationships of normal occlusion samples were very variable. 2. As the mandibular position was anterior to the maxilla, the maxillary incisors inclined more labially, the mandibular incisors more lingually, and the occlusal plane was flattened due to the anteroposterior dentoalveolar compensation. 3. As the vertical skeletal pattern was prominent, the upper anterior dentoalveolar height was increased, the lower posterior dentoalveolar height was decreased and upper posterior teeth was uprighted to the palatal plane and lower incisors and lower posterior teeth to the mandibular plane. 4. Lower incisors were more strongly associated with the dentoalveolar compensation than upper incisors according to the anteroposterior and vertical skeletal relationship.
Cluster Analysis ; Compensation and Redress* ; Dental Arch ; Dental Occlusion ; Incisor ; Jaw ; Maxilla ; Orthodontics ; Seoul ; Tooth

We performed radionuclide ventriculography before and within 1 week after percutaneous mirtal valvuloplasty(PMV) to evaluate left ventricular(LV) function in 20 patients(3 males and 17 females, mean age of 38±10 years) who were pure mitral stenosis before PMV and less than grade 1 mitral regurgitation developed after PMV. 9 out of 20 patients had atrial fibrillation and 3 patients developed a small left-to-right shunt(Qp/Qs<1.5)after PMV using double-balloon technique resulted in a increase in mitral valve area(0.9±0.3 to 2.1±0.8mm
Atrial Fibrillation ; Cardiac Output ; Female ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Radionuclide Ventriculography ; Stroke Volume

Gastric schwannoma is a very rare gastrointestinal mesenchymal tumor. Schwannoma in the gastrointestinal tract is usually not symptomatic, and preoperative abdominal CT or endoscopic evaluation cannot distinguish it from gastrointestinal stromal tumor. Surgical resection of this tumor is adequate to achieve a good prognosis. We performed laparoscopic gastric wedge resection in two patients who had the preoperative diagnosis of gastric gastrointestinal stromal tumor. In both cases, the postoperative immunohistochemistry staining was positive for S-100 protein and it was negative for CD34, which is consistent with gastric schwannoma. We report here on two cases of gastric schwannoma along with a review of the literatures.
Diagnosis ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Laparoscopy* ; Neurilemmoma* ; Prognosis ; S100 Proteins ; Tomography, X-Ray Computed

PURPOSE: The purpose of our study was to review the perinatal clinical characteristics of extremely low birth weight(ELBW) infants and determine their risk factors of their deaths. METHODS: The medical records of 96 infants weighing less than 1,000g, who were born at Seoul National University Hospital and admitted to our neonatal intensive care unit(NICU) were analyzed retrospectively on the basis of clinical characteristics, obstetrical problems, postnatal complications and outcome. RESULTS: The annual birth rate of ELBW infants was 0.11% to 0.90% of total live births and the mean annual birth rate was 0.56% at Seoul National University Hospital. Preeclampsia was the most common obstetrical problem(34.4%), followed by incompetent internal os of cervix(IIOC) (13.5%), multiple pregnancy(13.5%) and in vitro fertilization(IVF)(13.5%). Respiratory distress syndrome(RDS) was the most common postnatal complication(78.1%), followed by sepsis(60.4%) and apnea(39.6%). Comparing the ELBW infants weighing less than 750g with those weighing more than 751g, sepsis was more frequent in the latter group(p<0.05), whereas high grade intraventricular hemorrhage(grade Ill) was more frequent in the former group(p<0.05). Otherwise there was no statistically significant difference concerning the frequency of perinatal complications between two groups. Comparing the ELBW infants born before the year 1991, when surfactant treatment started to be used routinely at our NICU, with those born after the year 1991, apnea and sepsis could be observed more frequent in the latter group(p<0.05). Otherwise there was no statistically significant difference in the frequency of perinatal complications between two groups, The survival rate of ELBW infants was 0.0% in 1986, 50.0% in 1991 and 40.0% in 1995. The risk factors of neonatal deaths of ELBW infants included birth weight, gestational period, mode of delivery, IIOC, RDS, apnea, pneumonia, pneumothorax, acute renal failure(ARF) and infections(except pneumonia), but analyzing these risk factors by multivariate logistic regression analysis, the resultant significant independent risk factors consisted only of birth weight, RDS and pneumonia(p<0.05). There was no statistically significant difference in survival rate between ELBW infants born before and after the year 1991, but there was a tendency toward increasing survival rates in the latter group. CONCLUSION: Recently, the survival rate of ELBW infants is improving steadily, but is still lower than that of western countries and postnatal morbidity remains high. Therefore, there is an urgent need to give more efforts to the neonatal intensive care of ELBW inFants in order to increase survival rates and reduce postnatal morbidity. But it is more important to reduce preterm birth by the treatment of preventable obstetrical risk factors.
Apnea ; Birth Rate ; Birth Weight ; Humans ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Live Birth ; Logistic Models ; Medical Records ; Mortality ; Parturition ; Pneumonia ; Pneumothorax ; Pre-Eclampsia ; Premature Birth ; Retrospective Studies ; Risk Factors ; Seoul ; Sepsis ; Statistics as Topic* ; Survival Rate

Endothelin derived from the endothelial cells of microvessel is a potent vasoactive peptide, which has various physiologic actions in many internal organs. The fact that endothelin receptors are present on the osteoblastic cells suggests that endothelin play a role in bone metabolism. This study was done to study the effect of endothelin-1 on osteoblast and the combined effect of dexamethasone and endothelin-1 on osteoblast. Human osteoblasts isolated from ilium were cultured in DME/F12 medium, and divided into 5 groups; Group 1 (control), Group 2(10(-7)M endothelin-1), Group 3(10(-7)M endothelin-1+1:2500 monoclonal antibody), Group 4(10(-7)M dexamethasone+10(-7)M endothelin-1), and Group 5(10(-7)M dexamethasone). [3H]-thymidine uptake in groups was 23373.2+/-2722.4 cpm/well, significantly higher than that of control (P<0.05), and the increase was blocked by the addition of monoclonal antibody to endothelin(group 3). [3H]-thymidine uptake in groups adding steroid with or without endothelin was significantly lower than that of other groups (P<0.05). Group 2 showed marked increase in type I procollagen mRNA compared with other groups, but group 3 and 4 showed no significant effect on the expression of type I procollagen mRNA. In histochemical staining for alkaline phosphatase activity, the cells in groups with steroid were strongly positive in staining, large in size and looked well differentiated. Osteocalcin synthesis was also increased in groups with steroid treatment compared with other groups. This study demonstrated that endothelin-1 stimulated DNA synthesis and the expression of type I procollagen mRNA in human osteoblasts, and inhibited alkaline phosphatase activity, but had no significant effect on osteocalcin. Dexamethasone stimulated alkaline phosphatase activity and osteocalcin synthesis, and inhibited DNA synthesis but had no significant effect on the expression of type I procollagen mRNA. Dexamethasone masked the effect of endothelin-1 on human osteoblastic cells, and the effect of dexamethasone was predominant in the group of a combination of endothelin-1 and dexamethasone.
Alkaline Phosphatase ; Collagen Type I ; Dexamethasone ; DNA ; Endothelial Cells ; Endothelin-1 ; Endothelins* ; Humans ; Ilium ; Masks ; Metabolism ; Microvessels ; Osteoblasts* ; Osteocalcin ; Receptors, Endothelin ; RNA, Messenger

No abstract available.

OBJECTIVE: We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. METHODS: Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. RESULTS: The mean age of the patients was 70+/-13.4 years and the mean survival was 41.7+/-2.8 months. The mean survival of the poor functional outcome group (mRS> or =4) was 33.9+/-3.3 months, whereas that of the good functional outcome group (mRS< or =3) was 58.6+/-2.6 months (p value =0.000). The mean survival of the older patients (> or =70 years) was 29.7+/-3.4 months, whereas that of the younger patients (<70 years) was much better as 58.9+/-3.2 months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. CONCLUSION: Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.
Atrial Fibrillation ; Cerebral Infarction ; Diabetes Mellitus ; Heart Failure ; Humans ; Hypertension ; Infarction ; Infarction, Middle Cerebral Artery ; Life Expectancy ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Smoke ; Smoking ; Stroke ; Survival Rate