No abstract available.
Blotting, Southern* ; Diagnosis* ; DNA* ; Humans*

The redundant nerve root syndrome is not common and demonstrates a large, elongated, and tortuous nerve roots of cauda equina. Usually, the diagnosis of this syndrome is not difficult with the radiological finding and clinical symptom. The authors report a case of the redundant nerve root syndrome mimicking intradural spinal tumor in view of the symptom and radiological findings. Magnetic resonance imaging revealed a globular intradural mass just above canal stenosis. Decompressive laminectomy and durotomy improved back pain and radicular pain. From the experience of this case, the relief of nerve root compression is recommended as early as possible in the redundant nerve root syndrome.
Back Pain ; Cauda Equina ; Constriction, Pathologic ; Diagnosis ; Laminectomy ; Magnetic Resonance Imaging ; Radiculopathy

BACKGROUND: Atrial fibrillation is the most common sustained arrhythmia especially in the elderly. Despite the beneficial effect of anticoagulation to prevent disastrous complication of throm-boembolism, anticoagulation is not widely used in patients with atrial fibrillation. The purpose of this study was to identify the prevalence and clinical characteristics of atrial fibrillation and investigate the current status of anticoagulation in the elderly. METHODS: Through electrocardiographic analysis of 6,138 elderly (> or =65yr) patients from tan. to Dec. 1997, 386 patients with atrial fibrillation was found. Among the 386 patients, 274 patients with available medical records were enrolled for review of clinical findings (associated diseases, risk factor of throm-boembolism, medications) retrospectively. RESULTS: Mean age of population with atrial fibrillation was 72+/-6yr. The prevalence of atrial fibrillation was 6.2% and increased with age (65-69yr: 5.4%, 70-74yr: 6.4%, 75-79yr: 7.5%, 80yr-:9.0%). Atrial fibrillation with valvular hear disease was 27% of patients. Common associated diseases with nonvalvular atrial fibrillation were hypertension (48%), diabetes mellitus (18%), coronary artery disease (25%), congestive heart failure (21%), history of stroke or transient ischemic attack (27%). Anti-coagulation was used in 59% of valvular atrial fibrillation patients without contraindications (prosthetic valve: 100%, native valve: 42%), 24% of nonval-vular atrila fibrillation. Antiplatelet therapy with aspirin was 15%, 30% respectively, Aspirin was used in only 20% of atrial fibrillation patients with contraindication of anticoagulation. CONCLUSION: Atrial fibrillation is prevalent in the elderly. Anticoagulation and antiplatelet therapy in atrial fibrillation appears to be less than optimal.
Aged* ; Arrhythmias, Cardiac ; Aspirin ; Atrial Fibrillation* ; Coronary Artery Disease ; Diabetes Mellitus ; Electrocardiography ; Heart Failure ; Humans ; Hypertension ; Ischemic Attack, Transient ; Medical Records ; Prevalence ; Retrospective Studies ; Risk Factors ; Stroke ; Triacetoneamine-N-Oxyl

PURPOSE: A graft patency is influenced by various factors; the degree of preoperative ischemia, type of procedure, kinds of the conduit and the stati of inflow and outflow vessels. The aim of this study was to evaluate the patency rate according to the distal anastomosis level, kinds of conduit and the impact of runoff score. METHODS: Between August 1998 and August 2003, 141 lower extremity arterial bypass operations were performed. The runoff scores of the outflow arteries were graded according to the system proposed by the Ad Hoc Committee on Reporting Standards, SVS/ISCVS. The graft patency was determined by clinical examination, and ABI measurements, and with a Duplex scan if required, and assessed by a regular follow-up schedule. RESULTS: The primary patency rates according to the level of distal anastomosis at 1, 3 and 5 years were as follows; femoral artery (FA) 94.8, 87.1 and 87.1%, above-knee popliteal artery (AKPA) 83.7, 79.3 and 68.0%, below-knee popliteal artery (BKPA) 85.9, 64.4 and 42.9%, respectively, and the secondary patency rates; FA 95, 87.6 and 87.6%, AKPA 91.6, 68.3 and 38.6%, BKPA 83.8, 69.9 and 46.6%, respectively. The patency rates of below-knee popliteal bypass showed no statistical difference between each conduit, but showed a tendency to increase in the order: PTFE, vein patch and vein graft. No significant difference in the patency rate was shown except between a runoff score of 1 and above 1 at each level. CONCLUSION: The patency rates for the relatively proximal site of the distal anastomosis were superior to those of the distal site. The choice of conduit influenced the patency of infrapopliteal bypass grafts. The patent outflow vessels and the autogenous vein graft at infrapopliteal artery were more favorable for good graft patency. The recommended runoff score system seems to be revision in order to improve the predictability of a graft patency.
Appointments and Schedules ; Arteries ; Femoral Artery ; Follow-Up Studies ; Ischemia ; Lower Extremity* ; Polytetrafluoroethylene ; Popliteal Artery ; Transplants* ; Veins

140 patients of nontraumatic deep intracerebral hematoma, admitted at Kyungpook National University Hospital for 2 years, were evaluated through analysis for their therapeutic results. Two operative methods were adopted ; emergency craniotomy and burr hole aspiration applied each method to the patients occupied 35.7% of whole cases respectively and the remaining 28.6% went without operation. Most of the craniotomy was done within 24 hours after bleeding attack with a result of 82% of complete removal of hematoma. Burr hole aspiration was done within and around one to two weeks for perfect removal. Consciousness after removal of hematoma showed a remarkable improvement while motor weakness improved rather slowly. Therapeutic results of the whole patients at the time of discharge were following ; Good-15%, doing enough for daily life, Fair-56.4%, possible for carrying out daily routine in near future, and total death was 12 patients(8.6% of the whole) ; 7 patients(58.3%) due to direct effect by the hematoma and 5 patients(41.7%) due to infection and renal failure.
Consciousness ; Craniotomy ; Emergencies ; Gyeongsangbuk-do ; Hematoma* ; Hemorrhage ; Humans ; Renal Insufficiency

BACKGROUND: The restenosis after coronary angioplasty is the unresolved problem even if the improvement of interventional skills and pharmacological therapies. Nitric oxide, known as endothelial derived relaxing factor (EDRF), regulates the vascular tone and inhibits the proliferation of vascular smooth muscle cells and platelet adhesions and endothelium-leukocyte interactions. Nitric oxide is produced by endothelial nitric oxide synthase (eNOS). We studied the significance of eNOS gene polymorphism for the prediction of restenosis after coronary angioplasty in Koreans with ischemic heart disease. METHODS: We analyzed the two eNOS poly-morphisms using PCR (eNOS A/B polymorphism is the VNTR in intron 4 and eNOS T/G polymorphism is a missense mutation in exon 7) in 199 Korean patients who had 257 lesions undergoing percutaneous coronary angioplasty (ballooning=152, stenting=105). The angiography was repeated 6 months later to assess the relation between the rate of restenosis and types of eNOS gene polymorphism. RESULTS: We found no significant differences of restenosis rate in eNOS A/B and T/G polymorphism in those with balloon angioplasty or with stent (restenosis rate of A/A, A/B, B/B, respectively (n=257): 25% (1/4), 26% (14/53), 31% (62/200) (p=not significant), and T/T, T/G, G/G (n=249): 0% (0/3), 36% (16/44), 29% (58/202)(p=not significant)) Patients with A allele (non BB) or GG phenotype had lower restenosis rate, so we analyzed protective effect of non BB and GG phenotype on restenosis, but there was no significant statistical difference (restenosis rate of non BB and GG, BB and non GG respectively: 20% (15/57), 34% (16/47)(p=not significant)). CONCLUSION: eNOS A/B and T/G polymorphism is not associated with a significantly elevated risk of restenosis after coronary angioplasty.
Alleles ; Angiography ; Angioplasty* ; Angioplasty, Balloon ; Blood Platelets ; Exons ; Humans ; Introns ; Muscle, Smooth, Vascular ; Mutation, Missense ; Myocardial Ischemia* ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Phenotype ; Polymerase Chain Reaction ; Stents

Of the 68 cervical spondyltic patients showing symptoms of radiculomyelopathy, assessments were made on 29 patients who underwent neural decompressive surgery with cervical laminectomy through posterior approach for the results of surgery. Analyses were also made on the anterior-posterior diameters of cervical canal on the plain film of cervical spine. The mean values of anterior-posterior diameters measured on the levels of cervical C3-7 were 16.5+/-1.83 mm in the normal adult and 7.3+/-1.08 mm in the cervical spondylotic patients with radiculomyelopathy, which is far narrower than that of the normal. In cervical spondylotic patients, the anterior-posterior diameters of directly upper and lower parts of the lesions were 11.9+/-1.20 mm and 12.1+/-1.61 mm respectively, also much narrower mean values than those of the normal control group. The results of the 29 patients who received cervical laminectomy by posterior approach were much improved for 51.7% and improved for 44.8%.
Adult ; Humans ; Laminectomy ; Spine ; Spondylosis*

Among 51 intractanial AVM patients, 30 patients(58.8%) with AVM supplied mainly with PCA were studied for the relationship with feeding vessels, location and the size of AVM in connection with hemorrhage and also results in 20 surgical patients were analyzed. On cerebral angiogram, 56.7% accounted for AVM supplied only by PCA, 16.7% together with MCA and 26.6% with MCA and ACA. By location, 36.7% were for subcortical AVM and 63.3% were for deeply located paraventricular. 53.3% were large AVM and of them, 6.5% bleeded 30.0% accounted for small AVM, of which 88.9% bleeded. The total bleeding rate was high at 73.3%. Complete removal by surgery was available for 90.0%, and post operative improvement was at 75.0% with a mortality rate of 10.0%. 50.0% showed disappearance of seizure following total removal and 33.3% improved. 5.0%, however, had seizure for the first time following the surgery.
Hemorrhage ; Humans ; Mortality ; Passive Cutaneous Anaphylaxis* ; Posterior Cerebral Artery ; Seizures

The followings were evaluated as subjects of this study on 79 rebleeding cases of the 312 ruptures aneurysmal patients : incidence, time of rebleeding, location of rebleeding aneurysm, together with clinical grade and results of rebleeding. The incidence of rebleeding was 25.3% without prominent distinction between sexes. In the rebleeding rats by location, MCA aneurysm was found to be highest(30.8%) with no statistical significance. The 36.7% rebleeded in a week after initial bleeding, which indicates a daily average incidence of 5.3%. From one week on, the bleeding rate tapered off. Favorable risk patients showed a significantly higher rate(36.8%) compared with poor risk patients(6.7%). The mortality rate by rebleeding was 6.3%.
Aneurysm ; Animals ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Mortality ; Rats ; Rupture

BACKGROUND: Intimal hyperplasia and vascular remodeling are major mechanisms of restenosis after coronary artery angioplasty. Angiotensin II causes restenosis by stimulating cell proliferation and vascular constriction and nitric oxide prevents restenosis by inhibiting cell proliferation and stimulating vascular dilatation. Angiotensin converting enzyme (ACE) and nitric oxide synthase (NOS) are the main determinants of the activity of the angiotensin II and the nitric oxide. In this study, we tested whether the genetic polymorphisms of the ACE and the NOS gene are the risk factors of restenosis and whether the effect of the genetic polymorphisms in stent group is different from that in balloon angioplasty group. We also tested whether there are interactions among the polymorphisms. METHODS: We determined ACE I/D polymorphism and NOS A/B and G/T polymorphism in 219patients (77 patients (81 lesions) in stent group and 142 patients (181 lesions) in balloon angioplasty group) who underwent PTCA and follow up coronary angiography in Seoul national university hospital from January 1996 to May 1999. RESULTS: Restenosis (50% of reference diameter) was observed in 78/262(30%) lesions (18/81(22%) lesions in stent group, 60/181(33%) lesions in balloon angioplasty group). ACE DD genotype is the significant risk factor for increment of late luminal loss and loss index in stent group. In stent group, means of the late luminal loss and loss index of the lesions of the DD genotype are 1.12+/-0.61mm and 74.7+/-38.3% and those of the non-DD genotype are 0.72+/-0.77mm and 44.9+/-67.5% but DD genotype is not the risk factor for restenosis after balloon angioplasty. The restenosis rate, late luminal loss and loss index are not significantly different according to NOS polymorphisms. No significant interaction among the polymorphisms is observed. CONCLUSION: ACE DD genotype is a significant risk factor for restenosis after stent insertion but is not a risk factor for restenosis after balloon angioplasty in Korean. This result reflects the different mechanism of restenosis after stent insertion and balloon angioplasty. NOS polymorphisms are not associated with restenosis and no interaction between the polymorphisms is observed.
Angioplasty* ; Angioplasty, Balloon ; Angiotensin II ; Angiotensins* ; Cell Proliferation ; Constriction ; Coronary Angiography ; Coronary Vessels ; Dilatation ; Follow-Up Studies ; Genotype ; Humans ; Hyperplasia ; Korea* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Peptidyl-Dipeptidase A* ; Phenobarbital ; Polymorphism, Genetic ; Risk Factors ; Seoul ; Stents