Coenzyme Q is concentrated in Golgi apparatus membranes and mitochondria, but not in other membranes. Although it is difficult to prove the metabolic action of coenzyme Q administered exogenously in clinical cases, the effect of this substance can be evaluated by criteria based on clinical findings. In an attempt to evaluate the effect of coenzyme Q for the treatment of 67 patients(male 26 cases, female 41 cases) of congestive heart failure, we administered Coenzyme Q1030mg daily for 4 to 8 weeks. Most of them were valvular heart disease(74.6%) and hypertension (14.9%). Clinical effects were evaluated at least 4 weeks later by the criteria using a scoring method of severity of congestive heart failure which was devised by Ishiyama, etc. In summary, a definite effect was found in 13 cases(19%) and a mild effect was observed in 46 cases(69%). During treatment there were no significant side effects, and also no significant changes in heart rate and blood pressure.
Blood Pressure ; Estrogens, Conjugated (USP)* ; Female ; Golgi Apparatus ; Heart ; Heart Failure* ; Heart Rate ; Humans ; Hypertension ; Membranes ; Mitochondria ; Research Design ; Ubiquinone

The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows : Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.
Follow-Up Studies ; Tomography, X-Ray Computed

PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
Cardia ; Causality ; Cause of Death ; Drug Therapy* ; Granisetron* ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Nausea* ; Neoplasm Metastasis ; Platinum* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Vomiting*

We observed the levels of serum cholesterol, triglyceride and HDL-cholesterol in 28-hyperlipidemic patients after treatment with procetofene(Lipanthyl(R)), a new hypolipidemic agent. The results were as follows. 1. The hyperlipidemic patients were 7 cases of pure hypercholesterolemia, 12 cases of mixed hyperlipidemia and 9 cases of pure hypertriglyceridemia. 2. All the patients were treated with daily dose of 200 to 400mg, usually 300mg, and duration of more than 12 weeks. 3. The serum cholesterol decreased significantly at the rate of 29% in pure hypercholes terolemia and 29% in mixed hyperlipidemia after treatment for 12 weeks. 4. The serum triglyceride decreased significantly at the rate of 58% in mixed hyperlipidemia and 42% in pure hypertriglyceridemia after treatment for 12 weeks. 5. The serum HDL-cholesterol increased at the rate of 10% in pure hypercholesterolemia, 14% in mixed hyperlipidemia and 26% in pure hypertriglyceridemia after treatment for 12 weeks, but the increase rate was statistically significant only in pure hypertriglyceridemia. 6. Transient epigastric discomfort was complained by 2 patients, but subsided spontaneously with continuous treatment. 7. In view of these results, procetofene appears to be an effective and well tolerated agent for the treatment of all the types of hyperlipidemia.
Cholesterol ; Fenofibrate ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertriglyceridemia ; Triglycerides

We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung's disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P<0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
Child* ; Colon ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Enterocolitis, Necrotizing ; Female ; Hernia ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant* ; Intestinal Volvulus ; Mortality ; Prolapse ; Sepsis ; Skin ; Wounds and Injuries

BACKGROUND: Radiofrequency endovenous ablation of incompetent saphenous vein has gaining popularity over the conventional ligation and stripping as a minimally invasive technique. The latest version of radiofrequency endovenous catheter, VNUS(R)Closure fast VNUS medical Technologies, San Jose, CA, adopted a segmental ablation system, instead of continous pullback, is designed to reduce treatment time in comparison with the previous model-VNUS(R)Closure plus VNUS medical Technologies, San Jose, CA. The purpose of this study is to compare the difference between two endovenous radiofrequency ablation systems in terms of treatment efficacy and complication rates. We analyze the initial efficacy and complication rates of VNUS(R)Closure fast with VNUS(R)Closure plus. MATERIAL AND METHOD: Between June 2006 and August 2009, VNUS(R)Closure plus was performed to treat varicose vein on 59 limbs in 41 patients and VNUS(R)Closure fast was performed on 76 limbs in 67 patients. We retrospectively compared in both group with sex, mean treatment time, mean treatment diameter, conjugated treatment, and complications after the procedure. RESULT: All patient were symptomatic and diagnosed as varicose vein and underwent level 2 clinical classification with color duplex scan. The mean treatment time for the great saphenous vein was significantly less with VNUS(R)Closure fast (17.0+/-6.5 min) than VNUS(R)Closure plus (62.7+/-29.8 min). There was no significant difference in 1 yr closure rate between groups (p=0.32). Minor complications such as skin burn, thrombophlebitis, ecchymosis, hematoma, cellulitis, tenderness, and there were not different between the groups. CONCLUSION: Both VNUS(R)Closure fast and VNUS(R)Closure plus are effective methods of endovenous saphenous ablation. VNUS(R)Closure fast is superior to the previous model with less treatment time preserving compatible efficacy and complications. The efficacy of VNUS(R)Closure fast for long term closure rate remains to be established.
Burns ; Catheters ; Cellulitis ; Ecchymosis ; Extremities ; Hematoma ; Humans ; Ligation ; Retrospective Studies ; Saphenous Vein ; Skin ; Thrombophlebitis ; Treatment Outcome ; Varicose Veins

While colon perforation as a complication of diseases such as carcinoma, colitis, diverticular disease, or abdominal trauma is not uncommon, spontaneous perforation of the colon is rare. Although spontaneous perforation is classified as either stercoral or idiopathic on the basis of its etiological background, the pathological mechanisms of the lesions have yet to be determined in detail. Stercoral perforation is a very rare cause of acute abdomen, with fewer than 70 cases documented in the literature; and idiopathic perforation is also infrequently reported. Both disease entities have often been grouped together as idiopathic or spontaneous perforation, resulting in confusion. We report herein two cases of stercoral perforation of the sigmoid colon. The clinical features, diagnosis, and treatment of the disease are reviewed. Surgeons should be aware of the possibility of this fatal disease, despite its rare incidence. Furthermore, it is important to recognize the condition at an early stage of the disease because it has significantly high mortality if surgery is delayed.
Abdomen, Acute ; Colitis ; Colon* ; Colon, Sigmoid ; Diagnosis ; Incidence ; Mortality

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

Scalp avulsion is a devastating injury. The best possible procedure is replantation. Several successful scalp replantations with anastomoses of several vessels in large defects have been reported. In this report, we present a case of replantation of a large scalp avulsion using revascularizing with only one artery and vein. Despite the initial signs of flap congestion, we could predict the survival of the replanted scalp and terminate the procedure after detecting good perfusion and washout with indocyanine green fluorescence imaging. The procedure was successful following the patient’s recovery of sensory and sweating functions without complications such as flap necrosis or infection. Several important factors for successful scalp replantation with positive esthetic and functional outcomes were considered.