No abstract available.
Heterografts*

A rare case of a metastatic lesion of breast carcinoma in the talus of the left foot, approximately 14 months after simple mastectomy including resection of axillary lymph node is reported. The operation was undertaken 14 months prior to this admission and gradual onset of pain, swelling and redness were noticed about the left ankle. X-ray showed irregular osteolytic changes on the superolateral aspect of the body and the superior aspect of the neck of the left talus without periosteal reaction, Metastasis was confirmed by biopsy and pathological findings were also submitted.
Ankle ; Biopsy ; Breast Neoplasms ; Breast ; Foot ; Lymph Nodes ; Mastectomy, Simple ; Neck ; Neoplasm Metastasis ; Talus

No abstract available.
Korea* ; Mercury Poisoning*

This study was conducted to clarify the relationship of body fat percent with serum lipid level and blood pressure in adults. The study subjects were 472 men and l89 women who visited Multiphasic Health screening center of Yeungnam university Hospital in Taegu from May 20 to September 30, 1994. The relationship of serum lipid and blood pressure with BMl, Katsura index, atherogenic index, which calculated from the health screening data and body fat percent measured by impedance fat meter(model SIF-819) were analyzed. Three groups were classified as Group I(men: body fat percent > or= 20, women: body fat percent > or= 25, Group II (men: 15 < or = body fat percent <20, women: 20 < or = body fat percent<25, Group III(men: body fat percent <15. women: body fat percent<20) In this study, Group I accounted for 3.2%in men, 3.7%in women. Weight was significantly different among three groups in both sexes(p<0.01) and height was not significantly different among three groups. In men, serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein. atherogenic index were significantly different(p<0.01). In women, serum total cholesterol and low density lipoprotein were significantly different(p<0.05 but there was no differences in triglyceride and high density lipoprotein among three groups. BMl and Katsura index were significantly different among three groups in both sexes(p<0.01). In men, body fat percent was positively correlated with weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein, atherogenic index and systolic and diastolic blood pressures, and negatively correlated with high density lipoprotein. In women, body fat percent was positively correlated with age, height, weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein and atherogenic index, and negatively correlated with high density lipoprotein. But there was no significant correlation between body fat percent and blood pressure in women. In multiple regression analysis for total cholesterol, fat percent, age and BMl were significant independent variables in men(p<0.05, R2=0.1286), and body fat percent and age in women(p<0.05, R2=0.3399). In case of LDL/HDL ratio, only BMl was a significant independent variable in men(p<0.01, R2=0.0954), and body fat percent, age and BMl in women(p<0.05, R2=0.3164). In multiple regression analysis, age, low density lipoprotein and total cholesterol were significant independent variables on systolic blood pressure in men(p<0.05, R2=0.1297), age and total cholesterol in women(p<0.055, R2=0.1705). On diastolic blood pressure, only age was a significantly independent variable in men(p<0.01, R2=0.0972) and women(p<0.01, R2=0..1218). From the result of this study, it could concluded that body fat percent was significantly associated with other obesity indices and serum lipid, but had no significant association with blood pressure. To establish the relationship of body fat percent with blood pressure, further study which consider other variables that may have an effect on blood pressure should be performed.
Adipose Tissue* ; Adult* ; Blood Pressure* ; Cholesterol ; Daegu ; Electric Impedance ; Female ; Humans ; Lipoproteins ; Male ; Mass Screening ; Obesity ; Triglycerides

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

Two hundred and nine (41.6%) out of a total consecutive 502 patients who had undergone cardiac valve replacement with the St. Jude Medical valve from August 1984 to December 1995 were studied on the postoperative anticoagulant therapy. They were isolated mitral (MVR n=122), aortic (AVR n=39) and double mitral and aortic valve replacement (DVR n=48), respectively. All patients were placed on life-long oral coumadin treatment to keep the intensities of prothrombin activity within the prospectively set therapeutic target range of the International Normalized Ratios (INRs) between 1.5 and 2.5, which was managed by a single surgeon according to the monthly prothrombin time measurements through the visit to and examination along with continuing education at the out-patient clinic. The anticoagulation follow-up period extended to 1,082.0 patient-years (mean 62.1 months) during a total postoperative follow-up of 1,185.6 patient-years (68.1 months), and the INRs of 10,205 (mean+/-SD 48.8+/-25.1) prothrombin time measurements were available for the analysis. The INR values in the replacement groups as a whole were 2.034+/-0.660 in MVR, 2.010+/-0.600 in AVR and 2.072+/-0.738 in DVR; and the levels of the mean INRs in individual patient were 2.030+/-0.219 in MVR, 1.993+/-0.261 in AVR and 2.054+/-0.264 in DVR, respectively. The INR values, however, varied widely in the replacement group as a whole in distribution, and only 65.6% (6,690 of the total prothrombin time measurements) of INRs were within the therapeutic target range: 65.2% in MVR, 65.9% in AVR and 66.2% in DVR. Variations of INRs in individual patient were similarly broad throughout the follow-up period with the proportions of INRs within the target range of 65.0%+/-11.5% in MVR, of 63.9%+/-18.1% in AVR and of 64.7%+/-15.7% in DVR. In conclusion, patients are likely to be exposed to the high risks of thromboembolism from the inadequate anticoagulant intensities or of bleeding from the excessive anticoagulation sometime during the one-third of the follow-up in spite of strict adherence to the protocol of anticoagulation management. It was suggested strongly that the optimal and safe anticoagulation management should be directed toward minimization of the risky period of these complications in individual patient, and it was also stressed that the clinical reports of valve replacement should be accompanied with the practically achieved results of anticoagulation in detail.
Aortic Valve ; Education, Continuing ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves ; Hemorrhage ; Humans ; International Normalized Ratio ; Outpatients ; Prospective Studies ; Prostheses and Implants* ; Prothrombin ; Prothrombin Time ; Thromboembolism ; Warfarin

BACKGROUND: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. MATERIAL AND METHOD: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral (MVR 122), aortic (AVR 39) and double mitral and aortic valve replacement (DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios (INRs) within the low-intensity target range between 1.5 and 2.5. RESULT: A total anticoagulation follow-up period was 1082.0 patient- years (mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm (p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year (MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year (MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications (odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications (p<0.004 and p<0.002 respectively). CONCLUSION: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0~3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.
Ambulatory Care Facilities ; Aortic Valve ; Atrial Fibrillation ; Compliance ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves ; Hemorrhage ; Humans ; Incidence ; International Normalized Ratio ; Mitral Valve* ; Prostheses and Implants* ; Prothrombin Time ; Risk Factors ; Thromboembolism ; Warfarin

No abstract available.
Biopsy, Fine-Needle* ; Lung Neoplasms* ; Lung* ; Thoracic Wall* ; Thorax*

BACKGROUND: The nevus of Ota is a benign dermal melanocytic lesion that was previously proved difficult to treat. Recently, the Q-switched ruby laser and Q-switched Nd: YAG laser have been reported to by, successful in the treatment of benign pigmented lesions and tattos. OBJECTIVE: Our study evaluates the treatment of 60 patients with nevus of Ota with Q-switched Nd: YAG lase (l064nm). METHOD: Sixty patients with nevus of Ota were treated by the Q-switched Nd: YAG laser with pulse width 10nsec, and energy fluences ranging from 5.8 to 12J/cm and the laser repetition rate was 5 or 10Hz. The response to treatment was assessed by four independent investigators with photographs. RESULTS: 1. Total therapeutic effects of Q-switched Nd: YAG laser showed excellent result in 23.3%, good in 45%, fair in 18,3%, and poor in 13.3%. 2. Therapeutic effects by distribution proposed by Tanino showed excellent or good results in 84.6% at type Ia, 78.6% at, type Ib, 66.7% at type II, 60% at type III and 45.5% at type N. 3. Therapeutic effects by the number of treatments showed excellent or good results in 22.2% of patients after one treatment, 72.7% after two treatments, 93.3% after three treatments and 100% after four treatment. 4. Therapeutic effects by energy showed excellent or good results in 9.2% at energy range of 10 to 12J/arl and 66.6%, at energy range of 5.8-9.5J/cm. 5. Complications included transient hyperpigmentation (6.7% ), secondary bacterial infection (1.7 %), hypopigmentation (1.7%) and atrophic scar (1.7%). However these subsided spontaneously in a year. 6. The recurrence rate was 2.4%. CONCLUSION: The Q-switched Nd: YAG laser is a very effective mode of treatment for nevus of Ota which has provent unresponsive to other therapeutic modalities.
Bacterial Infections ; Cicatrix ; Humans ; Hyperpigmentation ; Hypopigmentation ; Lasers, Solid-State* ; Nevus of Ota* ; Nevus* ; Recurrence ; Research Personnel

No abstract available.
Humans