The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

PURPOSE: Post-authorization survey(PAS) is a useful tool for obtainting wider range of data on the safety and efficacy of new drugs following their approval, as they can detect uncommon, unreported adverse events(AEs), which enables more attention to be directed to the practioners. Especially, the limited number of patients in oncology trial cannot usually give the actual incidence of AEs. METHODS: Since Nov. 1998, when docetaxel gained Korean approval in the treatment of breast cancer, a PAS to investigate its safety profiles has been conducted targeting more than 600 patients over 4 calendar years. RESULTS: Case report forms from 626 out of 646 patients were assessable for safety and 444 for efficacy. The patient characteristics are: mean age, 48.1 years; male/female 4/622; Wt/Ht/BSA 57.9 kg/156.1 cm/1.56 m2 ; stage I-II/III/IV 109 (18.2%)/125 (20.8%)/366(61.0%). In 344 patients, 960 AEs were reported in severity of mild/moderate/severe in 6.7, 40.9 and 51.1 % of cases. From AE results, 36.0% needed dose reduction; 34.3% transient interruption of the cycle; and 1.3% permanent discontinuation of docetaxel. Thirty five serious AEs such as febrile neutropenia, alopecia, diarrhea, abdominal pain and headache were reported in 21 patients. Unexpected AEs such as skin ulcer, discoloration of skin, H. Zoster infection, ulticaria, facial flush, chest pain, hemoptysis, pneumonia, stridor, nasal bleeding, photophobia, haematuria, Cushing's syndrome, hyperglycemia and insomnia were reported regardless of any causal relationship. Factors affecting the development of AEs were age, stage, concomitant medication other than chemotherapeutic agents and the number of cycles treated. The efficacy was evaluable in 444 patients with overall response rate of 36.5% (CR/PR 6.3/30.2%). Factors affecting the efficacy were stage, concommitant medication other than chemotherapeutic agents and the number of treatment cycles. CONCLUSION: This post-authorization survey on the safety and efficacy of docetaxel in breast cancer offers oncology practice in the real world without subject selection as is the case in clinical trials, although it was performed to fulfill the registrative requirement of the Korean health authority with limited data. The efficacy and safety profile of docetaxel in breast cancer was no much different from those reported in clinical trials.
Abdominal Pain ; Alopecia ; Breast Neoplasms* ; Breast* ; Chest Pain ; Cushing Syndrome ; Diarrhea ; Epistaxis ; Febrile Neutropenia ; Headache ; Hemoptysis ; Herpes Zoster ; Humans ; Hyperglycemia ; Incidence ; Photophobia ; Pneumonia ; Respiratory Sounds ; Skin ; Skin Ulcer ; Sleep Initiation and Maintenance Disorders

PURPOSE: The purpose of this study was to evaluate the role of mast cell and histamine as typical product of mast cell in ischemia-reperfusion injury of muscle flap using H2 receptor blocker and mast cell stabilizer. METHODS: Thirty-five Sprague-Dawley rats weighing 250-300 gm were divided into four groups; Group I: Control group without ischemia, Group II: Normal saline injection group with ischemia, Group III: Cimetidine injection group with ischemia, Group IV: Sodium cromoglycate injection group with ischemia. Well established single pedicled transverse rectus abdominis musculocutaneous(TRAM) flap was designed in all rats and were rendered ischemia by clamping the artery for 150 minutes. All injections were applied intramuscular around gluteal area 30 minutes before reperfusion. The flap survival was evaluated at 7 days after operation. Neutrophil counts and mast cell counts were evaluated 24 hours after reperfusion. RESULTS: The difference of skin flap survival between control group and cimetidine injection group was not significant. In the normal saline injection group flap survival was markedly decreased compared to that of control group. The muscle flap survival was similar to the results of skin flap survival. The neutrophil counts were significantly decreased in control group and sodium cromoglycate injection group than normal saline injection group. The mast cell counts were significantly decreased in cimetidine injection group and control group than both normal saline injection and sodium cromoglycate injection groups. The protective effect of sodium cromoglycate was not seen in the skin flap, but the muscle flaps showed protective effects of sodium cromoglycate compared to normal saline injection group. CONCLUSION: It is suggests that commonly used antihistamine(H2 receptor blocker) has protective effect against ischemia-reperfusion injury to skin and muscle flaps by reducing neutrophil and mast cell. The mast cell stabilizer was not effective for skin flap but, possibly, for muscle flap.
Animals ; Arteries ; Cimetidine ; Constriction ; Cromolyn Sodium ; Histamine ; Ischemia ; Mast Cells* ; Neutrophils ; Rats* ; Rats, Sprague-Dawley ; Rectus Abdominis ; Reperfusion ; Reperfusion Injury* ; Skin

Surgical resection of esophageal cance has played a prominent role in both cure and palliation. The radiologic evaluation of postesophagectomy patients is directed at the detection of normal and pathological appearances after surgical resection. Since early detection of recurrent tumor is important in the management of patients who have undergone esophagectomy, we undertook a retrospective study to evaluate the findings of recurrence on CT in postesophagectomy patients. Between January 1988 and July 1991, 26 patients who had undergone transthoracic esophagectomy with esophagogastrostomy for epidermoid carcinoma of the esophagus with following reoccurance were examined by chest CT. The group included 25 male and one female patients were aged 45-71 years(mean, 53). All patients had studies done immediate post operative 7-10 days. The CT were performed with a CT 9800 scanner (GE Medical System, Milwaukee) after administration of oral contrast media and intravenous injection of contrast media. The findings seen on CT were cnfirmed by biopsy in five cases and by clinical, radiological follow-up manifestation in 21 cases. The abnormalities that were demonstrated on follow-up CT were adenopathy-mediastinal node(ten cases) or abdominal node(five cases), local recurrence-previous tumor site (five case), anastomotic siteI(two cases) or thoracases), peicardial effusion(two cases). Our results indicate that serial chest CT play an important role in the evaluation of the patients after transthoracic esophagectomy with esophagogastrotomy.
Biopsy ; Carcinoma, Squamous Cell ; Contrast Media ; Esophageal Neoplasms* ; Esophagectomy* ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Injections, Intravenous ; Male ; Recurrence ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed*

PURPOSE: A common side effect of the scalp reduction is a creation of a 'slot' with the hair growing in the opposite directions away from the scar. Overcoming the unnatural appearance of the slot has been a vexing problem in the scalp reduction surgery. None of the conventional corrective surgical techniques provides a complete and satisfactory aesthetic result. The Frechet flap is a triple transposition flap used for the correction of the slot defect secondary to scalp reduction surgery, seldom needing further scar revision. The Frechet technique provides a solution to the problem of the central slot concealment that is unattainable by other means, such as; Z-plasty and mini-graft. METHODS: Authors applied the Frechet technique to Asian patients who had undergone scalp reduction and operated on 4 patients from March, 2000 to January, 2001. Average follow-up period was 13 months. Patients with long scars passing through the temporoparietoccipital zone were excluded. All the undermining was performed in the subgaleal plane, reaching the upper auricular sulcus and stopping just above the nuchal ridge. RESULTS: None of the patients experienced infection, hematoma, nor any permanent hair loss. Transient telogen effluvium at the distal end of flap 2 and 3 was noticeable in one case. CONCLUSION: In conclusion, the results are aesthetically satisfactory without any significant complications.
Asian Continental Ancestry Group ; Cicatrix ; Follow-Up Studies ; Hair* ; Hematoma ; Humans ; Scalp

Behcet's disease is an uncommon disorder characterized by clinical triad of relapsing iritis, ulcer of mouth and genitalia. It is now recognized as a systemic disorder with mucocutaneous, ophthalmic, intestinal, respiratory, musculoskeletal, cardiovascular, urogenital and neurologic involvement. Systemic complications affecting the arterial system of disease are rare and mainly the aorta and iliac arteries are involved. Invasion of arterial wall is the most common lesion, predisposing to false aneurysm or rupture. As the standard open surgery, although often difficult, needed second surgeries in 30% to 50% of the patients due to the occurrence of anastomotic false aneurysms, endovascular repair emerged as an alter-native treatment of aneurysmal or pseudoaneurysmal manifestrations in Behcet's disease. We report here a case of the pseudoaneurysm at right subclavian artery which is successfully treated with percutaneous stent-graft.
Aneurysm ; Aneurysm, False* ; Aorta ; Behcet Syndrome* ; Genitalia ; Humans ; Iliac Artery ; Iritis ; Mouth ; Rupture ; Subclavian Artery* ; Ulcer

Recent studies have shown that side population (SP) cells, isolated from adult myocardium, represent a distinct cardiac progenitor cell population that exhibits functional cardiomyogenic differentiation. However, information on the intrinsic characteristics and endothelial potential, of cardiac SP cells, is limited. The present study was designed to investigate whether cardiac SP cells exhibit endothelial differentiation potential. The cardiac SP cells more highly expressed the early cardiac transcription factors as well as endothelial cell markers compared to the bone marrow-SP cells. After treatment with VEGF, for 28 days, cardiac SP cells were able to differentiate into endothelial cells expressing von Willebrand factor as determined by immunocytochemistry. Furthermore, expression of endothelial cell markers increased several-fold in VEGF-treated cardiac SP cells compared to the control group when assessed by real-time PCR. We also confirmed that cardiac SP cells provided a significantly augmented ratio of ischemic/normal blood flow, in the cardiac SP cell-transplanted group compared with saline-treated controls on postoperative days 7, 14, 21 and 28, in a murine model. These results show that cardiac SP cells may contribute to regeneration of injured heart tissues partly by transdifferentiation into angiogenic lineages.
Animals ; Base Sequence ; Bone Marrow Cells/cytology/drug effects ; Cell Differentiation/drug effects ; Cell Separation ; Colony-Forming Units Assay ; DNA Primers/genetics ; Endothelial Cells/*cytology/drug effects/metabolism/transplantation ; Mice ; Mice, Inbred BALB C ; Myocardium/*cytology/metabolism ; Vascular Endothelial Growth Factor A/pharmacology

PURPOSE: There were no accurate data of hematologic changes in the high school students in Korea since 1980'. Because of rapid growing of Korean students recently, it is necessary to reevaluate Korean data. So we compared hematologic changes in the students of general (GHS) and athletic high school (AHS) in Seoul city. METHODS: We reassured red cell count (RBC), hemoglobin (Hb), hematocrit (Hct), and related hematologic factors in the 452 GHS (male 290, female 162) as control group and the 138 AHS (male 70, female 68) as exercised group. Hematologic comparisons were performed between the students of AHS and GHS and the male and female students with t-test. RESULTS: 1) Values of RBC, Hb, Hct, MCHC, RDW were 4.6+/-0.3x1012/L, 13.4+/-1.2g/dL, 41.5+/- 3.4%, 32.2+/-0.5g/dL, 12.1+/-0.9% respectively in the male AHS and 5.2+/-0.3x1012/L, 15.2+/- 1.0g/dL, 46.7+/-3.0%, 32.5+/-0.5g/dL, 12.3+/-0.6% respectively in male GHS, and there were significant between compared data. 2) Values of RBC, Hb, Hct MPV were 4.5+/-0.3x1012/L, 13.6+/-1.2g/dL, 40.5+/-3.2%, 9.0+/- 0.6fl respectively in the female AHS and 5.0+/-0.5x1012/L, 14.9+/-1.3g/dL, 44.8+/-3.4%, 8.7+/- 0.8fl respectively in the female GHS, and significance were between compared data. 3) Values of MCH, MCHC, RDW, MPV were 30.1+/-1.8pg, 33.6+/-1.1g/dL, 12.8+/-1.1%, 9.0+/-0.6fl respectively in the female AHS and 29.3+/-1.8pg, 32.2+/-0.5g/dL, 12.1+/-0.9%, 8.7+/-0.9fl respectively in the male AHS, and there were significant between compared data. 4) Values of RBC, Hct, MCH, MCHC, RDW, PLT were 5.0+/-0.5x1012/L, 44.8+/-3.4%, 30.0+/-2.1pg, 33.4+/-1.1g/dL, 12.7+/-1.0%, 29.8+/-5.8x104/mm3 respectively in the female non-AHS, and 5.2+/-0.3x1012/L, 46.7+/-3.0%, 29.4+/-1.4pg, 32.5+/-0.5g/dL, 12.3+/-0.6%, 28.7+/- 5.8x104/mm3 respectively in the male non-AHS, and there were significant between compared data. CONCLUSIONS: Among the high school students, exercise caused several hematologic changes that were significant decline of the values of RBC, hemoglobin, hematocrit compared to control group regardless of sex. In female students, their values of MCH, MCHC, RDW were significantly increased compared to male students regardless of exercise.
Cell Count ; Female ; Hematocrit ; Humans ; Korea ; Male ; Seoul ; Sports

PURPOSE: There were no accurate data of hematologic changes in the high school students in Korea since 1980'. Because of rapid growing of Korean students recently, it is necessary to reevaluate Korean data. So we compared hematologic changes in the students of general (GHS) and athletic high school (AHS) in Seoul city. METHODS: We reassured red cell count (RBC), hemoglobin (Hb), hematocrit (Hct), and related hematologic factors in the 452 GHS (male 290, female 162) as control group and the 138 AHS (male 70, female 68) as exercised group. Hematologic comparisons were performed between the students of AHS and GHS and the male and female students with t-test. RESULTS: 1) Values of RBC, Hb, Hct, MCHC, RDW were 4.6+/-0.3x1012/L, 13.4+/-1.2g/dL, 41.5+/- 3.4%, 32.2+/-0.5g/dL, 12.1+/-0.9% respectively in the male AHS and 5.2+/-0.3x1012/L, 15.2+/- 1.0g/dL, 46.7+/-3.0%, 32.5+/-0.5g/dL, 12.3+/-0.6% respectively in male GHS, and there were significant between compared data. 2) Values of RBC, Hb, Hct MPV were 4.5+/-0.3x1012/L, 13.6+/-1.2g/dL, 40.5+/-3.2%, 9.0+/- 0.6fl respectively in the female AHS and 5.0+/-0.5x1012/L, 14.9+/-1.3g/dL, 44.8+/-3.4%, 8.7+/- 0.8fl respectively in the female GHS, and significance were between compared data. 3) Values of MCH, MCHC, RDW, MPV were 30.1+/-1.8pg, 33.6+/-1.1g/dL, 12.8+/-1.1%, 9.0+/-0.6fl respectively in the female AHS and 29.3+/-1.8pg, 32.2+/-0.5g/dL, 12.1+/-0.9%, 8.7+/-0.9fl respectively in the male AHS, and there were significant between compared data. 4) Values of RBC, Hct, MCH, MCHC, RDW, PLT were 5.0+/-0.5x1012/L, 44.8+/-3.4%, 30.0+/-2.1pg, 33.4+/-1.1g/dL, 12.7+/-1.0%, 29.8+/-5.8x104/mm3 respectively in the female non-AHS, and 5.2+/-0.3x1012/L, 46.7+/-3.0%, 29.4+/-1.4pg, 32.5+/-0.5g/dL, 12.3+/-0.6%, 28.7+/- 5.8x104/mm3 respectively in the male non-AHS, and there were significant between compared data. CONCLUSIONS: Among the high school students, exercise caused several hematologic changes that were significant decline of the values of RBC, hemoglobin, hematocrit compared to control group regardless of sex. In female students, their values of MCH, MCHC, RDW were significantly increased compared to male students regardless of exercise.
Cell Count ; Female ; Hematocrit ; Humans ; Korea ; Male ; Seoul ; Sports