No abstract available.
Fibronectins* ; Granulation Tissue* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: We performed this study to evaluate the long-term clinical prognosis, the effects of anti-anginal medicines on angina, and the factors on recurrence of angina in patients with angina and insignificant coronary artery stenosis (CAS). METHODS: The study population was consisted of 372 patients with angina and normal or minimal (less than 50 % stenosed) CAS out of 2475 consecutive patients who were performed coronary angiogram for 3.5 years. We reviewed the medical record of the study population. RESULTS: Myocardial infarction was developed in 2 cases (0.5%), recurrence of angina 59 cases (16%), and no death during mean 19 months follow-up period out of 372 patients. Patients with normal coronary artery (n=66) were younger (mean 54 yrs vs 59 yrs, p<0.001), had less incidence of diabetes (5% vs 13%, p<0.01), hypertension (19% vs 29%, p<0.05), recurrent angina (15% vs 18%, not significant), and myocardial infarction (0.4% vs 0.9%, not significant) than patients with minimal lesion (n=06). Anti-anginal medicine did not show benefits in relieving recurrent angina. Furthermore, in case of taking nitrates in patients with normal coronary artery, there was more frequent recurrence of angina (23% vs 13%, p<0.01) than not taking nitrates. There were no affecting factors to the recurrent angina among age, sex, ischemic changes on electrocardiogram, smoking, hypertension, diabetes, and hyperlipidemia. CONCLUSION: The long-term clinical outcomes in patients with insignificant CAS were good. Although there were no definite factors for recurrence of chest pain, administration of nitrates may cause more frequent angina in patients with normal coronary angiography.
Chest Pain ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Electrocardiography ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Medical Records ; Myocardial Infarction ; Nitrates ; Prognosis ; Recurrence ; Smoke ; Smoking

BACKGROUND: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. METHODS: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6-mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. RESULTS: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. CONCLUSIONS: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.
Biomechanical Phenomena ; Cadaver* ; Dislocations ; Ligaments* ; Muscles ; Scapula ; Shoulder

No abstract available.

PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

No abstract available.
Humans ; Microcomputers*

In this paper, the title was described incorrectly.

BACKGROUND: Heparin-induced thrombocytopenia/ thrombosis (HITT) is recognized as the most frequent and fatal symptom complexes in patients receiving heparin therapy. The antibodies of HITT are not directly bound to heparin but bound to complexes of heparin and platelet factor 4 (PF4) derived from platelet alpha-granules. That is, HITT IgG antibody-heparin-PF4 immune complexes are bound to FcgammaRII receptor of platelets, which induced thrombocytopenia. Some researches showed the antibodies reactive to platelets could be IgM or IgA as well as IgG. So in this study, the authors tried to explain the molecular basis of heparin-PF4-isoantibody complexes . METHODS: In HITT patients who had received long-term heparin therapy, we determined HITT isoantibodies and titers using heparin:PF4 ELISA. When fifteen HITT patients with high titer antibodies (more than 1 : 100) were selected, reaction patterns of isoantibodies with the platelets were examined through serotonin release test and flow cytometry. RESULTS: All patients showed one or more isotype antibodies and the most frequent isotype was IgGl (nine patients) . In the presence of optimal concentra pion of heparin and PF4, ten patients had antibodies which activated platelets, and all of them were positive in serotonin release test. Reactive plasmas had IgGl, IgG3, IgA or IgM antibodies, and each of them except one had IgGl. These platelet activations could be blocked in vitro by anti-IV.3 antibody. Non-reactive plasmas were negative In serotonin release assay nor had TgGl. The plasmas 4hat had two or more isoantibodies showed a similar pattern of the IgG antibody by flow cytometry. CONCLUSIONS: The HITT antibodies can be all kinds of antibody isotopes, but IgA and IgM may not bind to the platelets directly. It seems to be possible only after reacting with heparin-PF4-IgG complexes.
Antibodies ; Antigen-Antibody Complex ; Blood Platelets ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Heparin ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Isoantibodies ; Isotopes ; Mesons ; Plasma ; Platelet Activation ; Platelet Factor 4 ; Serotonin ; Thrombocytopenia ; Thrombosis*

BACKGROUND: Circadian rhythms have been described for many cardiovascular phenomenon, both physiologic and pathologic. However, its frequency of onset in nonsustained ventricular tachycardia(NVT) has rarely been studied. Hence, this study was performed to examine the occurence of circardian rhythm in patients with NVT and to access underlying factors affecting it. METHOD: Among about 2000 patients who had undergone 24-hour Holter recordings between 1988 and August 1992, 46 patients with one or more ventricular tachyardia(VT) episode were selected. In this group, subjects receiving antiarrhythmic drug, including beta blockers were excluded. RESULTS: The frequency of onset of circadian rhythm in NVT peaked between 10 to 11AM and 6 to 7PM. In patiens younger than 60 years, its frequency was highest between 9 AM to 12 noon and 6 to 8 PM, whereas peak occurred around 9 AM in the morning in other age groups. In addition, circadian rhythm was more frequent in female NVT patients between 9 to 11 AM, while peaking between 6 to 8 PM in male patients. Moreover, higher frequency was shown during the day in patients with underlying heart disease, although the peak occurred in 9 AM and 8 PM in patients without any heart disease. CONCLUSION: In NVT patients, the frequency of onset of circadian rhythm varied with time of the day, showing nearly equal peaks in the morning and in the evening. This is similar to rnythms described for acute myocardial infarction and sudden death. Furthmore, the occurrence was affected by age, sex and presence of underlying disease.
Circadian Rhythm ; Death, Sudden ; Female ; Heart Diseases ; Humans ; Male ; Myocardial Infarction ; Tachycardia, Ventricular*

Kimura's disease is a granulomatous disease which develops in the skin, subcutaneous tissues and lymph nodes and is characterized histologically by the presence of lymphoid follicles, vascular proli- feration and infiltration with eosinophils. The disease shows geographical predilection to Japan, China and South East Asia. The exact etiology and pathogenesis remain uncertain. Some patients had proteinuria or nephrotic syndrome. We have recently experienced the superimposed oliguric acute renal failure associated with Kimura's disease in a male patient with chronic renal failure who had been managed conservatively. Inguinal lymph node biopsy revealed Kimura's disease. He recovered from acute renal failure after being treated with hemodialysis and prednisolone. Lymphadeno- pathy and fever subsided with steroid treatment. We report a case of Kimura's disease which was complicated by acute renal failure in the patient with chronic renal failure.
Acute Kidney Injury* ; Biopsy ; China ; Eosinophils ; Far East ; Fever ; Humans ; Japan ; Kidney Failure, Chronic* ; Lymph Nodes ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Renal Dialysis ; Skin ; Subcutaneous Tissue