No abstract available.
Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

Lipoprotein(a)[Lp(a)] is a LDL-like particle with a glycoprotein called apo(a) attached to its apoB through disulfide bond. Many case-control studies support the opinion that plasma Lp(a) levels were associated with coronary artery disease. This study was conducted to assess the relationship between plasma Lp(a) level and coronary artery disease in Korean population. Serum levels of Lp(a), in addition to other lipids and known clinical risk factors for coronary artery disease were determined in 92 subjects undergoing coronary angiography. Among them 30 patients had no obstruction in the coronary artery(cath-control group), while the others revealed the presence of coronary artery stenosis more than 50%(CAD group). The Lp(a) levels of the CAD group were significantly higher the those of cath-control group(31.8+/-25.0mg/dl vs 14.6+/-11.9mg/dl, p<0.005). Other lipids except triglycerides(166.9+/-70.5mg/dl vs 116.2+/-56.1mg/dl, p<0.005) were not significantly different between two groups. The patients with significant coronary artery disease of two or more vessels were found to have higher Lp(a) levels than those of one vessel disease. Lp(a) levels had no relations with other lipids, diabetes, smoking, hypertension and age. Stepwise discriminant analysis revealed that Lp(a) was the best discriminator among risk factors for coronary artery disease. These results suggested that Lp(a) level was a significant independent risk factor for coronary artery disease.
Apolipoproteins B ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Glycoproteins ; Humans ; Hypertension ; Lipoprotein(a)* ; Plasma ; Risk Factors* ; Smoke ; Smoking

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

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm

"Dual LAD" was defined as the early bifurcation of the proximal LAD into two vessels : a short LAD which remained in the anterior interventricular sulcus and does not reach the apex, and a long LAD which leaves the anterior interventricular sulcus only to return to the distal sulcus and continue to the apex. Recognition of "Dual LAD" is essential to prevent errors of interpretation of the coronary arteriogram and for planning of optimal surgical therapy. We report 2 cases of "Dual LAD" with the review of the literatures.
Coronary Vessels*

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Certain angiographic patterns outlining the morphologic characteristics of vessels and defining the lesion-specific characteristics have recently been shown to greatly influence the likelihood of a successful dilation. In 1988, ACC/AHA Subcommitte on percutaneous transluminal coronary angioplasty proposed the lesion-specific classification as a guide for estimating the likelihood of a successful procedure as well as the the likelihood of developing abrupt vessel closure. To determine the lesion-specific predictors for successful dilation and complications after percutaneous transluminal coronary angioplasty, nine angiographic charateristics of 200 lesions in 164 patients who underwent coronary angiplasty between May, 1983 and September, 1989 were analyzed. 1) Successful dilation, defined as a reduction in stenosis diameter to less than 50% without acute myocardial infarction or emergency coronary artery bypass graft, occurred in 175 of 212 lesions(82.5%). 2) Successful dilation occurred in 13 of 15 type A lesions(86.6%), 148 of 178 type B lesions(83.1%) and 3 of 7 type C lesions(42.8%)(p<0.05 for A or B vs C). 3) Acute closure syndrome occurred in none of type A lesions, 6 of type B lesions(3.4%), 2 of type C lesions(28.5%)(p<0.005 for A or B vs C). 4) multivariate analysis showed that lesion-specific characteristic predictors for successful dilation were length of lesion(p<0.05) and accessibility(p<0.05) ; for ischemic events were major branch involvement(p<0.05) and eccentricity(p<0.05); for acute closure syndrome were accessibility(p<0.05) and eccentricity(p<0.05). 5) Procedural predictors for ischemic events were coronary artery dissection(p<0.01), post-PTCA diameter stenosis(p<0.05) and balloon/artery diameter ratio(p<0.01) ; For acute closure syndrome was coronary artery dissection(p<0.005). In this analysis, we found that angiographic lesion-specific characteristics related very importantly to procedural success and were able to define three major independent lesionspecific risk factors whose presence beforehand decreased the likelihood of successful dilation and increased the likelihood of acute closure. In the absence of any of these risk factors, the risk of acute closure is very small. Thus, identification of these factors and their associate risk should improve patients selection and better define the role of coronary angioplasty in the management fo patients with coronary artery disease.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Classification ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Emergencies ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Risk Factors ; Transplants

BACKGROUND: Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. METHODS: A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. RESULTS: The marginal bone loss at 12 weeks were 1.28+/-0.51mm, 1.32+/-0.57mm in the mesial and distal sides in group1, 1.94+/-0.75mm, 1.81+/-0.84mm in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. CONCLUSIONS: Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.
Alveolar Bone Loss ; Chlorhexidine ; Humans ; Sodium Chloride

PURPOSE: The aim of this report is to investigate the efficacy of anorganic bovine bone xenograft(Bio-Oss(R) ) at maxillary sinus floor augmentation. MATERIALS AND METHODS: Two male patients who missed maxillary posterior teeth were included. They were performed maxillary sinus floor augmentation using anorganic bovine bone xenograft(Bio-Oss(R) ). After 10 or 13 months, the regenerated tissues were harvested using trephine drills with 2 or 4mm diameter and non-decalcified specimens were made. The specimens were examined histologically and histomorphometrically to investigate graft resorption and new bone formation. RESULTS: Newly formed bone was in contact with Bio-Oss(R) particles directly without any gap between the bone and the particles. The proportions of newly formed bone were 23.4~25.3% in patient 1(Pt.1) and 28.8% in patient 2(Pt.2). And the proportions of remained Bio-Oss(R) were 29.7~30.2% in Pt.1 and 29.2% in Pt.2. The fixtures installed at augmented area showed good stability and the augmented bone height was maintained well. CONCLUSION: Anorganic bovine bone xenograft(Bio-Oss(R) ) has high osteoconductivity and helps new bone formation, so that it can be used in maxillary sinus floor augmentation.
Humans ; Male ; Mandrillus ; Maxillary Sinus ; Osteogenesis ; Sinus Floor Augmentation ; Tooth ; Transplants