PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*

In adolescents, sleep deprivation problem is getting worse, and increased caffeine consumption is considered to relieve the stress caused by sleep deprivation and academic burden. In this study, immediate neurologic effects of caffeine intake on adolescents were evaluated in three high school students using the γ-aminobutyric acid (GABA)/creatine ratio on magnetic resonance spectroscopy (MRS). MEGA-PRESS MRS and TE 135 ms single voxel MRS were performed in the anterior cingulate cortex before and after drinking a cup of coffee, which contained 104 mg of caffeine. GABA and creatine were measured on LCModel 6.3, respectively. In all three students, GABA/creatine ratios were decreased after caffeine intake. The GABA/creatine ratios obtained before caffeine intake were decreased after caffeine intake in all the three adolescents. In this preliminary study, caffeine intake caused an immediate decrease in the GABA/creatine ratio in the brain and it may be related to the neurologic effects of caffeine on an adolescent's brain.
Adolescent* ; Brain ; Caffeine* ; Coffee ; Creatine ; Drinking ; gamma-Aminobutyric Acid ; Gyrus Cinguli ; Humans ; Magnetic Resonance Spectroscopy ; Sleep Deprivation

In adolescents, sleep deprivation problem is getting worse, and increased caffeine consumption is considered to relieve the stress caused by sleep deprivation and academic burden. In this study, immediate neurologic effects of caffeine intake on adolescents were evaluated in three high school students using the γ-aminobutyric acid (GABA)/creatine ratio on magnetic resonance spectroscopy (MRS). MEGA-PRESS MRS and TE 135 ms single voxel MRS were performed in the anterior cingulate cortex before and after drinking a cup of coffee, which contained 104 mg of caffeine. GABA and creatine were measured on LCModel 6.3, respectively. In all three students, GABA/creatine ratios were decreased after caffeine intake. The GABA/creatine ratios obtained before caffeine intake were decreased after caffeine intake in all the three adolescents. In this preliminary study, caffeine intake caused an immediate decrease in the GABA/creatine ratio in the brain and it may be related to the neurologic effects of caffeine on an adolescent's brain.
Adolescent* ; Brain ; Caffeine* ; Coffee ; Creatine ; Drinking ; gamma-Aminobutyric Acid ; Gyrus Cinguli ; Humans ; Magnetic Resonance Spectroscopy ; Sleep Deprivation

No abstract available in English.
Clinical Study ; Humans ; Low Back Pain ; Psychological Tests

In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Acetabulum ; Dislocations ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Incidence ; Male ; Neck ; Necrosis ; Postoperative Complications ; Reoperation

Myxoma is the commonest intracardiac tumor and it is well known to present in bizarre ways. Calcification of the tumor is uncommon, though probably more frequent in right than in left heart tumors. Diagnosis can be followed by surgery with satisfactory results. A 36 years old man with partially calcified right ventricular myxoma and a 51 years old man with calcified left atrial myxoma, which were revealed different echogenic densities on 2-dimensional echocardiogram and gross calcification on fluoroscopy, were treated with surgical removal. We report above two cases of calcified myxoma with literature review.
Adult ; Diagnosis ; Fluoroscopy ; Heart Neoplasms ; Humans ; Middle Aged ; Myxoma*

Chronic mitral regurgitation may be well tolerated for decades because of favorable conditions like increased preload and decreased afterload. However, in some patients with underlying overt myocardial dysfunction, opertive correction of mitral regurgitation may result in persistent left ventricular dysfunction. Myocardial dysfunction in mitral regurgitation initially occurs subclinically and may becoma irreversible before symptoms of congestive heart failure develop. In order to identify latent myocardial dysfunction, we evaluated prognostic values of several indices from patient's characteristics, echocardiogram, cardiac catheterization data and contrast left ventriculogram in 49 patients with chronic mitral regurgitation who received mitral valve replacement. The patients were defined as Groups I who had improved symptoms with decreased left ventricular end-diastolic dimension after operation and Group II who had persistent symptoms and progressed left ventricular end-diastolic dimension, or not decreased until left ventricular end-diastolic dimension 60mm after operation. The results were as follows: 1) There was no significant difference in age, sex, duration of symptoms, preoperative NYHA functional status, and aortic cross clamping time during operation between Group I and Group II. 2) There was no significant difference in echocardiographic left ventricular end-diastolic dimension between group I and group II. There were significantly more dilated left ventricular end-diastolic dimension of Group II than that of Group I and significantly more depressed fractional shortening of Group II than that of Group I. There was significantly more increased end-diastolic wall stress of Group II than of Group I. 3) There was no significant difference in cardiac index, mean pulmonary artery pressure, mean pulmonary capillary wedge pressure and left ventricular end-diastoic pressure between Group I and Group II. 4) There were significantly more increased end-diastolic volume index and end-diastolic volum index of Group II than those of Group I, but no significant difference in ejection fraction between Group I and Group II. There was significantly more decreased ratio of end-diastolic circumferential midwall stress to end-diastolic volume index of Group II than that of Group I. 5) In Group I, end-systolic dimension, end-systolic dimension and end-systolic wall stress were decreased significantly after operation. In Group II, end-systolic dimension was decreased significantly after operation. 6) Values for combination of end-systolic left ventricular dimension greater than 28mm/m2 and end-systolic wall stress greater than 190mmHg predicted a Group II outcome with a sensitivity of 88.2%, a specificity of 93.8%, positive predictive value of 88.2% and negative predictive value of 93.8%. Values of combination of end-systolic left ventricular dimension greater than 28mm/m2 and fractional shortening less than 32% predicted a Group II outcome with a sensitivity of 88.2% a specificity of 90.6%, positive predictive value of 83.3% and negative predictive value of 93.5%, a specificity of 90.6%, positive predictive valve of 83.3% and negative predictive value of 93.5%. According to the above results, noninvasive hemodynamic variables such as end-systolic left ventricular dimension, fractional shortening and end-systolic wall stress would be useful guideline for follow-up and determining the optimal time for surgical intervention in patients with chronic mitral regurgitation.
Cardiac Catheterization ; Cardiac Catheters ; Constriction ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Hemodynamics ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sensitivity and Specificity ; Ventricular Dysfunction, Left

Voltage dependent calcium channels mediate wide variety of physiological functions including neurotransmitter release, neurite outgrowth, and gene expression in neurons. omega-Conotoxin-sensitive N-type calcium channels are exclusively expressed in nervous system and involved in the control of neurotransmitter release from neurons. In this experiment, I have investigated human chromosomal location and rat neuronal distribution of N-type voltage dependent calcium channel alpha1, subunit [alpha1B]. I have localized human alpha1B subunit gene to the long arm of chromosome 9[9q34] by fluorescent in situ hybridization. The distribution of rat alphaB1 subunit mRNA has been examined in the rat brain by in situ hybridization histochemistry and high level of alpha1B subunit mRNA has been observed in olfactory bulb, anterior olfactory nucleus, cerebral cortex, piriform cortex, hippocampus, dentate gyrus, parabrachial nucleus, and cerebellum and low level of expression was also found in other areas of rat brain.
Animals ; Arm ; Brain* ; Calcium Channels* ; Calcium Channels, N-Type ; Calcium* ; Cerebellum ; Cerebral Cortex ; Dentate Gyrus ; Gene Expression ; Hippocampus ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Nervous System ; Neurites ; Neurons ; Neurotransmitter Agents ; Olfactory Bulb ; Rats ; RNA, Messenger

OBJECTIVE: The aim of this study is to analyze relationships between dysphagia, and the timing and frequency of videofluoroscopic swallowing studies (VFSS) in patients with acute stroke. METHOD: We retrospectively reviewed the medical records of 111 patients with acute stroke whose dysphagia were evaluated by VFSS. The data were analyzed with descriptive statistics, t-test, and one-way ANOVA; Pearson correlation coefficient was also reported for all analyses. RESULT: Dysphagia was significantly different by transit time from stroke onset to arrival at the hospital (F=4.74, P=.011), paralysis site (F=3.05, P=.032), nasogastric tube (t=−3.81, P=.001), and diet just before the first VFSS (F=23.27, P<.001). VFSS timing was significantly different by smoking (t=2.88, P=.005), underlying disease (t=−3.58, P=.001), transit time from stroke onset to arrival at the hospital (F=5.90, P=.004), type of stroke (t=−5.24, P<.001), paralysis site (F=5.89, P=.001), nasogastric tube (t=−4.86, P=.001), surgery or angiography (t=−2.22, P=.032), level of consciousness (F=6.07, P=.000), length of stay (F=53.73, P=.001), department (F=16.37, P<.001), and diet just before the first VFSS (F=5.38, P=.006). VFSS frequency was significantly different by type of stroke (t=2.69, P=.008), nasogastric tube (t=−5.11, P=.001), length of stay (F=19.41, P=.001), department (F=7.18, P<.001), and the diet just before the first VFSS (F=16.67, P<.001). There was a significant correlation between dysphagia degree and the timing and frequency of VFSS. CONCLUSION: The more severe the degree of dysphagia, the longer the VFSS timing, and the greater VFSS frequency. The findings could be used for establishing systematic nursing care plans and active nursing intervention for dysphagia-related characteristics.
Angiography ; Consciousness ; Deglutition Disorders* ; Deglutition* ; Diet ; Humans ; Length of Stay ; Medical Records ; Methods ; Nursing ; Paralysis ; Patient Care Planning ; Retrospective Studies ; Smoke ; Smoking ; Stroke*