BACKGROUND: Several studies using intravascular ultrasound (IVUS) suggested several factors to predict angiographic restenosis or intimal hyperplasia(IH) after stenting. However, independent factors to predict IH have not been reported. Therefore, we evaluated the independent predictors of IH after stenting. METHODS: The serial (pre- and post-intervention, and follow-up) IVUS images were obtained in 77 patients with single stent implantation (GFX in 46 patients and NIR in 31). The matching IVUS image slices at 4 different sites within the same stent (follow-up lesion site, center of the stent and within 2 mm of proximal and distal margin of stent) were selected for serial comparisons. Total 308 matching images were obtained. A number of pre- and post-intervention IVUS variables including remodeling index =(lesion / proximal reference segment) pre-intervention vessel area were entered into multivariate linear regression analysis model to predict percent IH. RESULTS: The independent IVUS predictors of percent IH were pre-intervention plaque burden at follow-up lesion site (r=.252, p=.027) and proximal margin of the stent (r=.245, p=.034), and pre-intervention plaque burden (r=.334, p=.003) and remodeling index (r=0.353, p=.002) at the center of stent, and remodeling index at distal margin of the stent (r=0.230, p=.046). The percent IH positively correlated with pre-intervention plaque burden and inversely with remodeling index. CONCLUSIONS: The independent IVUS predictors of greater percent IH are larger pre-intervention plaque burden and smaller remodeling index.
Follow-Up Studies ; Humans ; Hyperplasia* ; Linear Models ; Stents* ; Ultrasonics* ; Ultrasonography

No abstract available.
Diaphragmatic Eventration* ; Humans ; Infant, Newborn*

No abstract available.
Pleural Effusion*

We have experienced acute hepatitis after general anesthesia. We guess that acute hepatitis is caused by enflurane anesthesia. We will report this case with references. A 34 year old pregnant woman suffered from preeclamsia. She admitted for emergence repeat cesarean-section due to labor pain. In this operation general anesthesia was performanced with enflurane. The preoperative liver enzyme were normal and other tests were within normal range. She developed high fever, marked elevation of serum glutamic oxaloacetic transaminase(SGOT)/serum glutamic pyrubic transaminase(SGPT)/ alkaline phosphatase(ALP)/total bilirunbin(T-B) on the 2nd postoperative day. She recovered gradually and discharged after 13 day's hospitalization. A possible cause of the acute hepatitis in this case were considered to be the enflurane.
Adult ; Anesthesia ; Anesthesia, General* ; Enflurane* ; Female ; Fever ; Hepatitis* ; Hospitalization ; Humans ; Labor Pain ; Liver ; Pregnancy ; Pregnant Women ; Reference Values

Diabetes is known to induce autonomic dysfunction and most experiments have been focused on the smooth muscle dysfunctions of the urinary bladder and corpus cavernosum in the genitourinary tract. The contractile response of the vas deferens is also decreased in diabetic rats and this effect may cause impairment of sperm transportation. However, few studies have been investigated the changes of contractility of the vas deferens in diabetic animals and little attention has been given to the differences between the contractilities of the prostatic and epididymal ends of the vas deferens in diabetic rats. In this study, the whole vas deferens was divided into two portions, prostatic and epididymal ends, and we examined the contractility of both segments to field stimulation at various frequencies from 4 to 64 Hz for 30 sec with pulses of 1 msec duration at 80 V in organ bath containing modified Tyrode's solution. Both initial twitch and the last contraction after 30 sec elicited by field stimulation were compared to clarify which component was more susceptible to field stimulation in control and diabetic rats. In the prostatic end, initial twitch was more impaired than the last contraction, which is believed that in diabetic rats, ATP(adenosine triphosphate) is more affected than NA(noradrenaline). In contrast, in the epididymal and the last contraction was more impaired than the initial twitch. In 64 Hz, initial twitch and the secondary contractions were not distinguished in the epididymal end of control rats, but in diabetic rats both phases were distinct. This means that the release of NA to field stimulation in the epididymal end is delayed in diabetic rats.
Animals ; Baths ; Muscle, Smooth ; Rats* ; Sperm Transport ; Urinary Bladder ; Vas Deferens*

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

We investigated the capacity of low dose aspirin in reducing the incidence of pregnancy induced hypertension and affecting the pregnancy outcomes in women at high risk for this disorder. And we also studied the efficacy of Doppler ultrasound as an effective means of selecting a patient population of good candidate to administer low dose aspirin. Seventy women with chronic hypertension or a history of severe preeclampsia in their previous pregnancy were randomly assigned to treated group receiving low dose aspirin(60 mg/d, n=32) or control group(n=38). Daily administration of low dose aspirin could not prevent the development of pregnancy induced hypertension in the treated group(21.9% vs. 28.3%, p > 0.05). And there was no differences between the treated and control groups in the rates of emergency cesarean section for fetal distress(6.3% vs. 10.3%, p > 0.05), neonatal intensive care unit admission(9.4% vs. 15.8%, p > 0.05), fetal growth retardation(15.6% vs. 13.2%, p > 0.05), and perinatal death(3.1% vs. 7.9%, p > 0.05). In the group showing abnormal Doppler flow velocity waveform, aspirin seemed to improve the mean gestational age(35.7+/-2.8 vs. 34.4+/-3.1 weeks), birth weight(2271.9+/-730.8 vs. 1887.0+/-619.0 gm) and the pregnancy outcomes(31.3% vs. 60.6%), however, these results were not statistically significant(p > 0.05). This study suggests that low dose aspirin therapy is not effective in reducing the incidence of pregnancy induced hypertension. However, combination of Doppler ultrasound study with low doe aspirin therapy may improve pregnancy outcomes in women with high risk pregnancy.
Aspirin* ; Cesarean Section ; Emergencies ; Female ; Fetal Development ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Parturition ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy, High-Risk* ; Ultrasonography*

No abstract available.
Heart* ; Thoracic Surgery*

PURPOSE: To investigate the relationship of MIS and cryptorchidism according to the descending level of testis into scrotum, we studied expression degree of MIS by immunohistochemical analysis using anti-human MIS polyclonal antibody in testicular specimen. MATERIALS AND METHODS: MIS were stained in excised testis by trauma on each 8 patients as control group and age-matched abdominal, inguinal and prepubic cryptorchidism. The expression were classified as score 1, 2, 3 and 4 according to stained degree of percentage in randomized 16 fields(x400) under the light microscope. RESULTS: Of the degree of MIS expression in control group, 87.5% were category 3 or more. The mean score was 3.13+/-0.62. 2. Of the degree of MIS expression in abdominal type cryptorchid testis group that underwent orchiectomies, 68.7% were category 1. The mean score, 1.31 +/- 0.48, showed significant difference compared to control group(p<0.05). 3. Of the degree of MIS expression in inguinal type,56.2% were category 3 or more. The mean score, 2.63+/- 0.81, showed no significant difference compared to control group(p>0.05). 4. Of the degree of MIS expression in prepubic type, 75.0% were category 3 or more. And the mean score, 2.88+/-0.62, showed no significant difference compared to control group(p>0.05). CONCLUSIONS: Expression of MIS is different according to descending level of testis and may play a role in physiologic changes of testicular descent.
Cryptorchidism* ; Humans ; Male ; Orchiectomy ; Scrotum ; Testis*

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.
Animals ; Humans ; Inflammation ; Liposomes ; Male ; Models, Animal* ; Plasma ; Prostate ; Prostatitis* ; Rats* ; Rats, Wistar ; Spectrum Analysis ; Urethra ; Zinc*