During the 6 year period, frorn May 1, 1989 to August 31, 1995, 40 cases of endometrial carcinoma were encountered at College of Medicine, University of Ulsan, Asan Medical Center. The purpose of this study is to investigate the patient's clinical characteristics and to correlate these findings with the there histopathologic results. The results were as follows : 1. There was an increasing tendency of endometrial carcinoma during 3-year time interval between May 1, 1989 and August 31, 1995. 2. Age distribution of the patients with endometrial cancer showed; 10% for the 31s ages<40, 27.5% for the 41.
Age Distribution ; Chungcheongnam-do ; Endometrial Neoplasms* ; Female ; Humans ; Ulsan

BACKGROUND AND OBJECTIVES: The purposes of this study were to provide evidence of any correlation between the endothelial dysfunction and the extent of coronary atherosclerosis, and the relationship between the endothelial function and individual atherosclerosis risk factors in patients with significant coronary artery stenosis. SUBJECTS AND METHODS: The endothelial function was measured by hyperemia induced brachial artery dilation, using high resolution ultrasound, in 284 consecutive patients (mean age 59 years, men: 176) having undergone coronary angiography. The subjects were divided into four groups according to the number of coronary arteries narrowed by more than 50%; 0 (n=88), 1 (n=98), 2 (n=54) and 3 (n=44). The endothelial functions were compared to see if significant coronary artery disease was present, according to the groups and the presence of individual atherosclerosis risk factors. RESULTS: There were no significant differences in the endothelial dysfunction between the narrowed and normal coronary artery groups (4.66+/-2.45% vs. 4.43+/-1.53% p>0.05) or between the four groups. The endothelial function in patients with significant coronary artery stenosis (n=196) was significantly lower when coupled with hypertension (n=84, 2.99+/-2.4% vs. 4.20+/-2.4%, p<0.05), diabetes (n=44, 4.07+/-2.7% vs. 4.84+/-2.5%, p<0.05) and hypercholesterolemia (n=82, 4.26+/-1.9% vs. 4.95+/-2.7%, p<0.05), but not with smoking. CONCLUSION: The endothelial function showed no difference according to the extent of coronary atherosclerosis. Risk factors of atherosclerosis, such as hypertension, diabetes mellitus and hypercholesterolemia, can deteriorate the endothelial function further, even in the patients with significant coronary artery stenosis.
Atherosclerosis ; Brachial Artery ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels ; Diabetes Mellitus ; Endothelium, Vascular ; Humans ; Hypercholesterolemia ; Hyperemia ; Hyperlipidemias ; Hypertension ; Male ; Risk Factors ; Smoke ; Smoking ; Ultrasonography

OBJECTIVES: The purpose of this study is to evaluate the incidence of secondary T wave changes in WPW syndrome and the relation between the incidence of the secondary T wave changes and sex, age (duration of preexcitation), mean and maximal QRS duration (from the onset of delta wave to the end of S wave) of standard 12 lead electrocardiogram (ECG) and the site of accessory pathway (AP). The secondary purpose of this study is to evaluate the relation between the site of secondary T wave changes and the location of the AP. METHODS: Of the total 128 patients (pts) with WPW syndrome, standard 12 lead ECGs of 125 pts (mean age 35, male 71 pts) who were free from bundle branch block (n=2) and myocardial ischemia (n=1) were analyzed. The locations of Aps were divided into 4 categories (anterior, left lateral, posterior and right lateral) by intracardiac mapping. RESULTS: 82 (66%) pts of 125 pts showed secondary T wave changes. The incidence of secondary T wave changes was not related to sex or duration of preexcitation, but mean QRS duration (<0.12: 46%, 0.12: 88%, p<0.001), maximal QRS duration (<0.12: 32%, 0.12: 73%, p<0.001) and the site of AP (right: 80%, left: 54%, p=0.003). The most frequent lead showing secondary T wave changes in ECG was lateral (lead I, aVL) in pts with anterior (43%, 9 out of 21), posterior (50%, 25 out of 50) and right lateral (86%, 6 out of 7) AP. But, no secondary T wave change was found in most pts with left lateral (n=47) AP. CONCLUSION: The incidence of the secondary T wave changes in pts with WPW syndrome is high (66%). These changes are not related to sex and duration of preexcitation, but to the mean and maximal QRS duration during preexcitation and the location of the AP. The ECG lead showing secondary T wave changes in pts with WPW syndrome appears to be related to the location of the AP and the most frequent lead is I and aVL.
Bundle-Branch Block ; Electrocardiography ; Humans ; Incidence ; Male ; Myocardial Ischemia ; Wolff-Parkinson-White Syndrome

BACKGROUND: In aerometabolic process, the human heart mainly utilizes free acid as fuel. During anaerobic process, lactate production by the myocardium is increased and accumulates in the myocardium. Thus it decreases the contractility of myocadium. Therefore in patients with ischemic heart disease, lactate prodution must be increased by the myocardium during myocardial ischemia. During paroxysmal supraventricular tachycardia, patients frequently experience chest pain and ST segment depression suggesting acute myocardial ischemia. However it occurs on a physiologic basis independent of ischemia. The purpose of this study was to assess whether tachycardia induced by artial pacing produces myocardial ischemia in patients without evidence of ischemic heart disease. METHODS: Between May 28, 1996 and August 13, 1996, at the University of Keimyung, Dong-San Medical center, 15 patients(male 9, female 6, mean age of 38 years) with palpititation underwent electrophysiologic testing and had radiofrequency cather ablation. There were no evidence of ischemic heart disease. Right artrial pacing was done with lengths of 500msec, 400msec and 350msec in each 5 patients. A 12 lead electrdcardiogram, left ventricular enddiastolic pressure, blood from femoral artery and coronary sinus for lactate determinations and blood gas analysis were dbtained simultaneously. They were obtained at baseline, at 1, 5, 10 and 15 minute of atrial pacing and at 1, 5, 10 minute after cessation of pacing. RESULT: Significant changes were not observed in , , concentration of , pH and saturation. In all patients, mean percent lactate extraction was above 10% and not significantly changed during atrial pacing. However ST segment depression was significantly progressive during atrial pacing and according to decrease the cycle length(p<0.05), also left ventricular end-diastolic pressure was significantly decreased during atrial pacing(p<0.05). Conclusion: Therefore tachycardia induced by atrial pacing for 15 minutes did not produce myocardial ischemia in patients without evidence of ischemic heart disease. Depression of STsegment during supraventricular tachycardia or atrial pacing, in patient without underlying heart disease is necessary to inveestigate what makes this phenomenon.
Blood Gas Analysis ; Blood Pressure ; Chest Pain ; Coronary Sinus ; Depression ; Female ; Femoral Artery ; Heart ; Heart Diseases ; Humans ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Metabolism* ; Myocardial Ischemia ; Myocardium ; Tachycardia ; Tachycardia, Supraventricular

BACKGROUND: Recently, the incidence of acute myocardial infarction (AMI) rapidly increased with prolongation of life spans, improvements of food and life styles in Korea. The mortality rate of AMI is higher than other disease. The purpose of this study is to evaluate which factors can affect the early outcome of AMI in Korean. METHODS: A retrospective clinical study was done on 555 consecutive patients{Male:Female=387 (69.7%):168 (30.3%), mean age 61.3 years} with AMI who had been admitted to Dong-San Medical Center from January 1990 to May 1997 . The subjects were devided into two groups. Group I was dead patients during the in-hospital period (85 patients, 15.3%), and Group II was living patients (470 patients, 84.7%) wen they discharged from hospital. We compared clinical and laboratory results in both groups and analysed the cause of death according to the time of death during hospitalization. RESULTS: The results were as folows; 1) The mean age and female percentage of Group I (65.4 years, 43%) were higher than Group II (60.5 years, 28%). The mean of systolic/diastolic blood pressure and percentage of smoker of Group I (108/65mmHg, 48%) were lower than Group II (125/76mmHg, 65%), significantly. 2) The degree of Killip classification was higher in Group I (class 1:29.4%, II:18.8%, III:21.2%, IV:30.6%) than in Group II patients (class 1:73.4%, II:13.6%, III:8.7%, IV:4.3%), significantly. 3) 47 patients were died first day of hospitalization and the most common cause of death was cardiogenic shock (27 patients, 31%). The most common cause of death within 1 week was cardiogenic shock, afterthen congestive heart failure. 4) The most common cause of death in Killip class I patients was ventricular tachycardia or ventricular fibrillation and in Killip class II-IV patients was cardiogenic shock. CONCLUSION: The risk of in-hospital death was higher in elderly, female sex, and patients with higher killip classification. Cardiogenic shock was most common cause of death within 1 week, and was congestive heart failure after 1 week.
Aged ; Blood Pressure ; Cause of Death ; Classification ; Female ; Heart Failure ; Hospitalization* ; Humans ; Incidence ; Korea ; Life Style ; Life Support Care ; Mortality ; Myocardial Infarction* ; Retrospective Studies ; Shock, Cardiogenic ; Tachycardia, Ventricular ; Ventricular Fibrillation

A massive intracoronary thrombus, during percutaneous coronary intervention (PCI), implies a high risk of major adverse cardiac events. We experienced a case of successful PCI, using Percusurge(r), in an acute myocardial infarc-tion patient, with massive intracoronary thrombi. The TIMI 3 coronary flow could not be restored during a primary PCI of the right coronary artery, despite repeated ballooning, intracoronary urokinase injection, parenteral abciximab and heparin. However, successful PCI, with stenting, was performed by aspiration of the large intracoronary thrombi, with the Percusurge(r) system, 5 days after the primacy PCI.
Angioplasty, Balloon, Coronary ; Coronary Vessels ; Heparin ; Humans ; Percutaneous Coronary Intervention* ; Stents ; Thrombosis ; Urokinase-Type Plasminogen Activator

A massive intracoronary thrombus, during percutaneous coronary intervention (PCI), implies a high risk of major adverse cardiac events. We experienced a case of successful PCI, using Percusurge(r), in an acute myocardial infarc-tion patient, with massive intracoronary thrombi. The TIMI 3 coronary flow could not be restored during a primary PCI of the right coronary artery, despite repeated ballooning, intracoronary urokinase injection, parenteral abciximab and heparin. However, successful PCI, with stenting, was performed by aspiration of the large intracoronary thrombi, with the Percusurge(r) system, 5 days after the primacy PCI.
Angioplasty, Balloon, Coronary ; Coronary Vessels ; Heparin ; Humans ; Percutaneous Coronary Intervention* ; Stents ; Thrombosis ; Urokinase-Type Plasminogen Activator

BACKGROUND AND OBJECTIVES: The carotid intima-media thickness, endothelial function and arterial stiffness have been shown to be parameters of atherosclerosis. We have performed this study to evaluate the impact of atherosclerotic coronary risk factors on several atherosclerotic parameters in patients with coronary artery disease. SUBJECTS AND METHODS: The study subjects consisted of one hundred and forty (140) consecutive patients (mean age: 61 years, and 85 males), who demonstrated via coronary angiogram more than 50% stenosis in at least 1 major coronary artery. In an overnight fasting state, the carotid intima-media thickness (IMT), and endothelial function (flow-mediated brachial artery dilatation, FMD) were measured by high-resolution ultrasound, and arterial stiffness (pulse wave velocity, PWV) was measured by using a non-invasive pulse wave analyser. RESULTS: The hypertensive group showed more evidence of greater arterial stiffness (aorta; 8.5+/-1.0 m/s vs. 7.9+/-1.2 m/s, p=0.004, and greater stiffness of the artery of the lower extremity; 9.2+/-1.2 m/s vs. 8.7+/-1.3 m/s, p=0.010), which was measured by the pulse wave velocity, than that of the normotensive group. The carotid IMT and the endothelial function showed no significant differences between the two groups. Furthermore, these parameters did not show significant differences with other parameters such as diabetes mellitus, smoking, and hyperlipidemia. Multivariate analysis revealed that hypertension and systolic blood pressure were still the independent factors of arterial stiffness, but carotid IMT and endothelial function were not independent factors. CONCLUSION: Hypertension and systolic blood pressure are the independent factors of arterial stiffness in patients with coronary artery disease (CAD), but this study did not show that carotid IMT and endothelial function made a significant difference in arterial stiffness. However, in this study, other risk factors were not associated with the differences of these parameters.
Arteries ; Atherosclerosis ; Blood Pressure ; Brachial Artery ; Carotid Intima-Media Thickness ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diabetes Mellitus ; Dilatation ; Endothelium ; Fasting ; Humans ; Hyperlipidemias ; Hypertension ; Lower Extremity ; Multivariate Analysis ; Pulse Wave Analysis ; Risk Factors* ; Smoke ; Smoking ; Tunica Intima ; Ultrasonography ; Vascular Stiffness

Sex-cord stromal tumors of ovary account for 5~8% of all ovarian malignancies. This group of ovarian neoplasms is derived from the sex cords and the ovarian stroma or mesenchyme. Although they can occur in women of all ages, they tend to have peak incidence in those over age50. So they should be surgically managd with hysterectomy and bilateral salpingo-oophorectomy. The purpose of this study is to report the experience at Asan Medical Center, Department of Obstetrics and Gynecology, in 24 patients with ovarian sex-cord stromal tumortreated between May, 1989 and April, 1995. We analyzed the effect of histologic subtype, FIGO stage, age and management. The results were as follows: 1. In histologic subtypes, fibrothecoma(66.7%), granulosa cell tumor(20.8%), Sertoli-Leydig cell tumor(8.3%), others(4.0%) were counted in order. 2. The mean age of sex cord-stromal tumor was 44.0 years and 8 cases(33.4%) of tumors over the age of 50.0 years, 13 cases(54.2%) over the age of 40.0 years. 3. Main initial symptoms were abdominal pain(37.5%), asymptomatic cases(25.0%), abdominal mass palpation(16.6%), irregular menstruation(12.5%) in order. 4. Management was surgery only(91.7%), surgery and chemotherapy(8.3%). 5. The mean disease free survival was 30.6 months.
Chungcheongnam-do ; Disease-Free Survival ; Female ; Granulosa Cells ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Mesoderm ; Obstetrics ; Ovarian Neoplasms ; Ovary* ; Sex Cord-Gonadal Stromal Tumors

Sex-cord stromal tumors of ovary account for 5~8% of all ovarian malignancies. This group of ovarian neoplasms is derived from the sex cords and the ovarian stroma or mesenchyme. Although they can occur in women of all ages, they tend to have peak incidence in those over age50. So they should be surgically managd with hysterectomy and bilateral salpingo-oophorectomy. The purpose of this study is to report the experience at Asan Medical Center, Department of Obstetrics and Gynecology, in 24 patients with ovarian sex-cord stromal tumortreated between May, 1989 and April, 1995. We analyzed the effect of histologic subtype, FIGO stage, age and management. The results were as follows: 1. In histologic subtypes, fibrothecoma(66.7%), granulosa cell tumor(20.8%), Sertoli-Leydig cell tumor(8.3%), others(4.0%) were counted in order. 2. The mean age of sex cord-stromal tumor was 44.0 years and 8 cases(33.4%) of tumors over the age of 50.0 years, 13 cases(54.2%) over the age of 40.0 years. 3. Main initial symptoms were abdominal pain(37.5%), asymptomatic cases(25.0%), abdominal mass palpation(16.6%), irregular menstruation(12.5%) in order. 4. Management was surgery only(91.7%), surgery and chemotherapy(8.3%). 5. The mean disease free survival was 30.6 months.
Chungcheongnam-do ; Disease-Free Survival ; Female ; Granulosa Cells ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Mesoderm ; Obstetrics ; Ovarian Neoplasms ; Ovary* ; Sex Cord-Gonadal Stromal Tumors