No abstract available.
Osteoma, Osteoid* ; Spine*

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

PURPOSE: A retrospective study was performed to find any indicator to predict the difficulty of percutaneous transhepatic biliary drainage(PTBD) before the procedure and to evaluate correlationship between the chronological change of fluoroscopic time and the operator's experience. MATERIALS AND METHODS: The materials included the consecutive 138 cases of PTBD of 120 patients with obstructive jaundice. Under the presumption that the difficulty of procedure would be reflected on fluoroscopic time, the correlation between fluoroscopic time and eight factors(i. e. ;sex, age, disease, approach, degree of IHD dilatation, total bilirubin, alkaline phosphatase, and operator) were analysed. Also chronological change of fluoroscopic time in three operators, who performed more than 25 procedures, were evaluated. RESULTS: Statistically significant factors were operator (P=0.000), sex (P:0.028), approach(P=0.048), and total billrubin (P=0.021). Good correlation between the chronological change of fluoroscopic time and the operator's experience was found. CONCLUSION: The significant factors could be used as an indicator to predict the difficulty before PTBD procedure. The chronological change of fluoroscopic time could be used as an indirect estimate in the stabilization of the operator fechnigue.
Alkaline Phosphatase ; Bilirubin ; Dilatation ; Humans ; Jaundice, Obstructive ; Retrospective Studies

OBJECTIVE: To evaluate the factors that affect torque control during anterior retraction when utilizing the C-retractor with a palatal miniplate as an exclusive source of anchorage without posterior appliances. METHODS: The C-retractor was modeled using a 3-dimensional beam element (0.9-mm-diameter stainless-steel wire) attached to mesh bonding pads. Various vertical heights and 2 attachment positions for the lingual anterior retraction hooks (LARHs) were evaluated. A force of 200 g was applied from each side hook of the miniplate to the splinted segment of 6 or 8 anterior teeth. RESULTS: During anterior retraction, an increase in the LARH vertical height increased the amount of lingual root torque and intrusion of the incisors. In particular, with increasing vertical height, the tooth displacement pattern changed from controlled tipping to bodily displacement and then to lingual root displacement. The effects were enhanced when the LARH was located between the central and lateral incisors, as compared to when the LARH was located between the lateral incisors and canines. CONCLUSIONS: Three-dimensional lingual anterior retraction of the 6 or 8 anterior teeth can be accomplished using the palatal miniplate as the only anchorage source. Using LARHs at different heights or positions affects the quality of torque and intrusion.
Displacement (Psychology) ; Incisor ; Splints ; Tooth ; Torque

To investigate the clinical usefulness of the intravenous anesthesia of the facial chemical peeling with midazolam(0.1 mg/kg)-fentanyl(3 ug/kg) - esmolol(initial 500 ug/kg,maintenance 200 ug/kg/min), the authors took 133 cases into consideration. The results of the statistical evaluation were as follows: 1) Most of the cases were small pox scar(70.7%). 2) One point five percent of the cases dreamed during anesthesia. 3) Ninety-four point seven percents of the cases were in the emotion of "Peaceful and relaxed" and 60.1% of them were in the mood of Pleased or very pleased and the others were "So and so". 4) Ninety-one point seven percents of the cases were willing to choose the same anesthetic method next time. 5) Fifty-two point six percents of the cases showed hypertensive episodes during anesthesia. 6) The incidence of the cases with SaO lower than 85% was 36.8%. The anesthetic technique with intravenous midazolam-fentanyl-esmolol for the facial chemical peeling with trichloroacetic acid(TCA) gives the patient comfortness and preference for this anesthetic technique. Close monitoring of the respiration is needed, because it can depress respiratory function. And control of the high blood pressure during anesthesia seems to be needed.
Anesthesia* ; Anesthesia, Intravenous ; Deep Sedation* ; Dreams ; Fentanyl* ; Humans ; Hypertension ; Incidence ; Midazolam* ; Respiration

BACKGROUND AND OBJECTIVES: Homocysteine is a metabolite of methionine metabolism with atherogenic and thrombotic properties. Increased blood homocysteine has been recognized as a risk factor for atherosclerotic coronary artery disease, but it is not much to be clarified in this country. MATERIALS AND METHOD: In a case-control study, we examine the relationship between the risk of atherosclerotic coronary artery disease and serum total homocysteine, folate, vitamin B12, vitamin B6, and other conventional risk factors. Thirty nine patients with significant stenosis of epicardial coronary artery and 20 healthy age-sex matched control subjects were included. Fasting venous blood was obtained and serum total homocysteine (tHCY) concentration was measured by high performance liquid chromatography and fluorescent detection method. RESULTS: Compared with control group, case group had higher tHCY concentrations (14.9+/-6.9 vs 10.8+/-4.2 mol/L, p<0.05) and lower folic acid concentration (6.7+/-3.6 vs 11.0+/-5.7 ng/mL,p<0.05). There were higher tHCY concentrations of patients with 2 vessel and 3 vessel disease than that of patients with 1 vessel disease (17.2+/-6.7 and 18.4+/-9.8 micro mol/L vs 12.4+/-3.9 micro mol/L,p<0.05). Vitamin B12 and vitamin B6 concentrations showed no significant difference between case group and control group. Compared with control group, there were more smokers (51.5% vs 25.0%, p<0.05), and patients with hypertension (39.4% vs 0%, p<0.001) and diabetes (30.3% vs 0%, p<0.001) in case group. Increased tHCY (tHCY over 14.7 mol/L) was an independent risk factor for atherosclerotic coronary artery disease (OR; 6.75, 95% CI; 1.15 - 40.99, p<0.05) together with smoking (OR; 5.4, 95% CI; 1.22 - 23.95, p<0.05). CONCLUSION: These data support the hypothesis that elevated serum tHCY concentration is a risk factor for Korean patients with atherosclerotic coronary artery disease, and low folate concentration may be responsible for elevated tHCY concentration.
Case-Control Studies ; Chromatography, Liquid ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Folic Acid ; Homocysteine* ; Humans ; Hypertension ; Metabolism ; Methionine ; Risk Factors* ; Smoke ; Smoking ; Vitamin B 12 ; Vitamin B 6

BACKGROUND AND OBJECTIVES: The recovery of the left ventricular ejection fraction (LVEF) appeared to be prognostic of survival in congestive heart failure (CHF). The aim of our study was to evaluate the parameters that appear to predict the LVEF recovery in CHF. SUBJECTS AND METHODS: Forty-nine patients, with CHF and a LVEF< 35%, were enrolled. Doppler myocardial imaging was performed on 5-basal and 5-mid segments in order to assess the systolic duration, the time from the R-wave to the peak systolic velocity (RS time) and the time from the R-wave to the peak early diastolic velocity (RE time). The standard deviation (SD) of the RS time was an indicator of the 'systolic synchronicity'. After at least 3 months of full medical therapy, a follow-up echocardiography was performed. According to the changes in the LVEF, the patients were divided into groups I (< 5%, n=29) and II (> or =5%, n=20). RESULTS: The baseline clinical and echocardiographic parameters were similar in both groups. In group II, the LV end-systolic and end-diastolic volumes were decreased, but the LVEF was increased by up to 44% at the follow-up. The right ventricular annulus velocity (group I: 6.7+/-2.1 vs. group II: 8.0+/-2.0 cm/sec, p< 0.05), the use of beta-blocker (69 vs. 100%, p< 0.05) and the SD of the RS time (46+/-21 vs. 21+/-12, p< 0.01) were significantly different between the two groups. However, the systolic duration and the SD of the RE time were similar in the two groups. From a multivariate analysis, only the SD of the RS time was an independent predictor of the LVEF recovery. CONCLUSION: Myocardial systolic synchronicity is an important predictor of the LVEF recovery.
Echocardiography ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart Failure* ; Heart Ventricles* ; Humans ; Multivariate Analysis ; Recovery of Function* ; Stroke Volume

BACKGROUND AND OBJECTIVES: Several echocardiographic methods, such as ejection fraction, fractional shortening, and Doppler tissue imaging (DTI), have been developed to quantify systolic function but all had several important limitations. The purpose of this study was to quantify the regional wall motion abnormality, using strain, in an acute myocardial infarction, compared with a visual estimation. SUBJECTS AND MEHTODS: Forty-five patients, with acute anterior (n=28) and inferior myocardial (n=17) infarctions, who underwent color DTI, were examined using longitudinal strain and standard echocardiography, and the results were compared with 54 normal controls. A total of 594 segments [3 segments (apical, mid and basal portion) of septum and inferior wallx99 patients] were evaluated. RESULTS: In the normal control group, the strain was uniformly distributed in all segments (-20%~-23%). In the infarction groups, the strain was negatively related with the wall motion score. The strain of the apical segments and mid-septum was decreased in the anterior wall infarctions, and the strain of basal septum and mid to basal inferior wall was decreased in the inferior wall infarctions. The dyskinetic segments showed positive strain. CONCLUSION: This study validates strain as a superior method for the quantification of the regional wall motion abnormality in an acute myocardial infarction than visual estimation.
Echocardiography ; Humans ; Infarction ; Myocardial Infarction*

BACKGROUND AND OBJECTIVES: Although the size of the coronary artery is known to be closely related to the outcome of coronary artery bypass grafting and percutaneous coronary intervention, its normal value and determinants have not been examined in Koreans. SUBJECTS AND METHODS: One hundred and twenty seven normal coronary arteriograms were carefully selected from 3,412 studied consecutively. Of these, 53 women and 23 men, with no abnormalities in their cardiac function and not using nitrates, were studied. The lumen diameter was measured at 10 segments in the epicardial coronary arteries. RESULTS: For men, the mean lumen diameter of the proximal left anterior descending and left circumflex coronary arteries were 3.88+/-0.39 and 3.45+/-0.47 mm, respectively, and were not affected by the anatomic dominance. However, the left main and proximal right coronary arteries varied between 4.44+/-0.49 and 5.18+/-0.32 mm (p<0.05) and 3.29+/-0.60 and 4.05+/-0.42 mm (p<0.05), respectively, by the anatomic dominance. Women had a smaller mean coronary artery size than men [for diameter, -7% (p<0.01);for cross-sectional area, -13% (p<0.01)], and the left ventricular (LV) mass was significantly associated with coronary artery diameter (p<0.05). From a multiple linear regression analysis, gender was an only independent predictor of the coronary artery size (p<0.05). CONCLUSION: We revealed normal coronary artery dimensions in Koreans. Although, body size, hypertension, use of calcium channel blockers, anatomic dominance and age had no effect on the size of the coronary artery, but the LV mass and gender were shown to have an effect. The multivariate regression analysis showed gender was an only independent predictor of the coronary artery size.
Asian Continental Ancestry Group ; Body Size ; Calcium Channel Blockers ; Coronary Artery Bypass ; Coronary Vessels* ; Female ; Humans ; Hypertension ; Linear Models ; Male ; Nitrates ; Percutaneous Coronary Intervention ; Reference Values*

Although dextrocardia occurs rarely, the incidence of coronary artery disease is similar to the general population. Because of unfamiliarity with performing catheterization, transradial coronary angiography has seldom been performed in a patient with dextrocardia. We successfully performed left transradial coronary angiography in a patient with a right side heart using counter-directional torquing of the catheters and mirror-image angiographic angles.
Catheterization ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Dextrocardia ; Heart ; Humans ; Incidence