No abstract available.

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

PURPOSE: This study was to prepare the basic data for prevention of colo-rectal cancer and protection against its spread. METHOD: The subjects for the study were 204 patients with colo-rectal cancer from the G.S. wards of five general hospitals in Busan for the period of June 1 to September 1, 2001. The instrument used was a questionaire which was developed by Junho Shin(1995). The data was analyzed by descriptive statistics, McNemar test, x2 test, paired t-test, and ANOVA. RESULT: 1. 57% of the studied subjects were male, 42.7% were more than 60 years old, 54.9% were of standard physique, 49.5% were the Buddhists, 50.5% were the middle or high school graduates, 83.8% were city dwellers, 48% were jobless, 69.6% had no-history of alimentary disease, 44.1% had no-family history of cancer, 82.8% were married. 2. Constipation(x2=36.45, p=0.0001) in clients showed a significant positive association for the pre- diagnosed, but diarrhea(x2=3.947, p=0.047) showed a significant positive association for the post-diagnosed. The preference for high seasonings(t=6.23, p=0.0001) and animal fat (t=8.35, p=0.0001) was higher significantly in the pre-diagnosed, but physical activities(x2= 30.22, p=0.0001), an eutrophic or tonic medicine(x2=30.22, p=0.0001), was of and vegetables(t=-6.20, p=0.0001) was higher significantly in the post-diagnosed. 3. There were significant differences in the life style of the pre-diagnosed according to the general characteristics except religion. CONCLUSION: Results of the above study reveal we should be very sensitive to the change of defecation styles and consider the necessity of improving life styles as regards eating habits. When an education program is developed, the general characteristics of the subjects need to be considered.
Animals ; Busan ; Defecation ; Eating ; Education ; Hospitals, General ; Humans ; Life Style* ; Male ; Middle Aged

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

Infantile hypertrophic pyloric stenosis (HPS) is a relatively common entity. A number of studies for the postoperative feeding schedule has been studied to allow for earlier hospital discharge and improve cost-effectiveness in the treatment of HPS. The purpose of this study was to compare 3 feeding-methods and to evaluate the usefulness of ad lib feeding for HPS. The authors retrospectively reviewed the records of 116 patients who underwent pyloromyotomy for HPS from 1995 to 2004. Three cases were excluded because of the duodenal perforation during pyloromyotomy. Three feeding-methods were defined as: Conventional feeding (>10 hours nothing by mouth and incremental feeding every 2 hours, C), Early feeding(for 4 to 8 hours nothing by mouth and incremental feeding every 2 hours, E), and Ad lib feeding (for 4 hours nothing by mouth and ad lib feeding, A). Time to normal feeing in C, E and A were 51+/-24, 34+/-12 and 24+/-6 hours, respectively. Hospital-stay in C, E and A were 72+/-17, 55+/-13 and 43+/-12 hours, respectively. There were statistically significant differences according to the method of feeding. Frequency of postoperative emesis in C, E and A were 38%, 47% and 53%, but was not significant statistically. Ad lib feeding decreased time to normal feeding and hospital stay, and did not increase postoperative emesis. We conclude that ad lib feeding is recommended for patient with pyloromyotomy in HPS.
Appointments and Schedules ; Fees and Charges ; Humans ; Length of Stay ; Mouth ; Postoperative Nausea and Vomiting ; Pyloric Stenosis, Hypertrophic* ; Retrospective Studies

Appendicitis is a common disease in children. But left lower abdominal pain in acute appendicitis is a rare clinical feature. A 6 year-old-girl complained of left sided abdominal pain for 2 days. Past medical history was not contributory. Abdominal tenderness and guarding in left lower quadrant were noticed. Abdominal sonography and abdominal computed tomography scan demonstrated reversed position between superior mesenteric artery and vein, and a mass in the left lower quadrant abdomen suggesting appendicitis. Acute appendicitis in left lower quadrant, associated with intestinal malrotation, was found at laparatomy.
Abdomen ; Abdominal Pain ; Appendicitis* ; Child* ; Humans ; Mesenteric Artery, Superior ; Veins

BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
Acinetobacter ; Acinetobacter baumannii ; Anti-Bacterial Agents ; APACHE ; Case-Control Studies ; Compliance ; Disease Transmission, Infectious ; Disinfection ; Epidemiologic Studies ; Hand Hygiene ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Length of Stay ; Medical Records ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sputum ; Suction

Acutely aggravated dissecting flap and consequent occlusion of the superior mesenteric artery (SMA) by simple contrast passage during initial angiography for percutaneous stent placement is a uncommon event, which usually is not reported. After analysis of many factors that underlie development of such complications, we present herein one case of successful treatment of isolated SMA dissection and its complications with favorable outcomes during 25 months follow-up after percutaneous stent placement.
Adult ; Aneurysm, Dissecting/*surgery ; Angiography/adverse effects ; Contrast Media/adverse effects ; Embolectomy ; Humans ; Male ; Mesenteric Artery, Superior/radiography/*surgery ; Mesenteric Vascular Occlusion/etiology ; Stents/*adverse effects ; Tomography, X-Ray Computed

There are several treatment modalities of cerebral arteriovenous malformation, among these, stereotactic radiosurgery is effective means of obliteration of AVM with minimal morbidity. Since July 1988 to May 1998, our institute have conducted 98 radiosurgery for arteriovenous malformations. During this period, there were 2 major changes in delivering radiation, the first one is introduction of compute r dose planning system at september 1996(CUMC normal mode), the next was CUMC Stereotactic mode using non-flat filter delivery system since september 1997. Authors report the results of the first generation LINAC(linear Accelerator) radiosurgery before introduction of computer dose planning system for radiosurgery. During the first generation period(July 1988 to september 1996), 70 patients have had stereotactic radiosurgery for vascular malformation. Among these, 49 patients could be followed at least for 2 year with angiography or MRA(magnetic resonance angiography). Hemorrhage was the most common presenting causes of undergoing radiosurgery, the parietal lobe was the most prevalent area undergoing radiosurgery for vascular malformations. With grouping of volumes, vascular malformations we re grouped as 1) volumes less than 1 ml(n= 14 ), 2) 1- 4ml (n=21), 3) 4-10ml (n=4 ), 4 ) 10-14ml(n=4 ), 5 ) volumes over 14ml (n=6). the results are as follows ' for group 1 ), total occlusion rate were 85.7 F, for group 2 ) total occlusion rate were 71.4 %, for group 3 ),4 ),5 ), total occlusion rate were 50%. As a gross result of 49 patients, total occlusion rate was 69.4%, partial occlusion was 22.4%, no response 14.3 %. 4 cases of 70 radiosurgery for vascular malformation rebleeded (5.7 %) and 2 of these patients died of bleeding (2.9%). There was no symptomatic radiation complication, but 6 patients showed increased signal intensity on T2 weighted image on follow up magnetic resonance imaging.
Angiography ; Arteriovenous Malformations ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations ; Magnetic Resonance Imaging ; Parietal Lobe ; Radiosurgery* ; Vascular Malformations

Streptococcus Gallolyticus subspecies pasteurianus is a biotype II/2 of Streptococcus bovis. Although there is a clear correlation between Streptococcus bovis bacteremia and the risk of developing colon cancer, the relationship between Streptococcus gallolyticus subspecies pasteurianus bacteremia and colon cancer is not clear. We report a 53-year-old female who initially presented with fever and low back pain. Streptococcus gallolyticus subspecies pasteurianus was isolated in blood cultures, so we performed a colonoscopy and discovered colon cancer.
Bacteremia* ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Female ; Fever ; Humans ; Low Back Pain ; Middle Aged ; Streptococcus bovis ; Streptococcus*