We report a case of nonsyphilitic isolated coronary ostial stenosis of the left main coronary artery observed by transesophageal echocardiography(TEE) in a 52-year-old woman with angina. The lesion was suspected during coronary angiography and it was not visualized by transthoracic echocradiography. Coronary ostial stenosis, which is potentially lethal as left main coronary artery disease, occurs rarely in the absence of other coronary artery disease. The diagnosis of ostial stenosis has been usually made by the use of coronary angiography, however, it may be difficult to diagnose at angiography if angiographic catheter is positioned across the stenotic lesion, and the unexpected serious complication during coronary angiography in such a patient may happen. The new ultrasonic imaging technique of TEE provides more detailed images of proximal coronary anatomy and coronary blood flow.
Angiography ; Catheters ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Female ; Humans ; Middle Aged ; Ultrasonography

No abstract available.
Humans ; Primary Health Care*

The antihypertensive efficacy and safety for once daily dosing of amlodipine, a new calcium channel blocker, was studied in a series of 36 patients with essential hypertension. The starting dose of amlodipine were 5mg/day, which were doubled after 4 weeks, if normalization of diastolic blood pressure was not reached. Amlodipine induced a clinically significant reduction in blood pressure(17.7mmHg in systolic blood pressure and 11.9mmHg in diastolic blood pressure) with similar heart rates after 12 weeks therapy. The efficacy of amlodipine therapy was noted an excellent in 18 patients(51.4%), good in 8 patients(22.9%), fair in 5 patients(14.3%), and failed in 4 patients(11.4%). There were few side reactions such as fatigue, headache, constipation and indigestion, but all studied patients completed for 12 weeks therapy except one patients who did not return. And also there was no abnormal results of laboratory tests before and after the amlodipine therapy. This results indicated that amlodipine is an effective and safe new long-acting calcium channel blocker in the treatment of hypertension.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dyspepsia ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension*

PURPOSE: In this study, we aimed to find useful methods for diagnosis and treatment of hyperthyrotropinemia in neonates showing normal T4 and elevated TSH levels in neonatal screening test. METHODS: We retrospectively reviewed the medical records of 16 male and 26 female neonates whose T4 were normal and TSH were elevated in the neonatal screening test from 1994 to 2006. The clinical data, including perinatal history, thyroid function test and radionuclide scannig was analysed. RESULTS: Of the forty-two patients, male was 38.1% and female was 61.9%. Mean T4 and TSH level were 8.61+/-1.55 ug/dL, 49.66+/-36.56 uU/mL respectively. At the recheck, when recalled, TSH were normalized in 8 patients (19.1%), still elevated in 34 patients (80.9%). (99m)TC thyroid scan was performed in 36 cases. The results were normal in 18 cases (50.0%), diffuse enlargement in 11 cases (30.5%), ectopic thyroid, poor visualization, hypoplasia respectly in 11.2%, 5.5%, 2.8%. Fourteen patients (33.3%) had histories of povidone use for umbilical care. Of the 42 patients, 27 (64.0%) cases were treated by thyroid hormone, 15 cases (36.0%) were followed up without treatment. Among 15 cases without treatment, 8 patients showed TSH normalization at 1.5 months, 5 patients at 3 months, one patient at 6 months and one patient at 9 months. Among 27 cases with treatment, 18 cases (66.7%) are being treated, 5 cases (18.6%) are being treated more than 3 years, the 3-years treatment was ended in 6 cases (22.2%), follow up loss was 3 cases (11.1%). CONCLUSION: At long term follow up, TSH was normalized in many patients who showed normal T4 and elevated TSH levels in neonatal screening test. Imaging study such as (99m)TC thyroid scanning was helpful to decide whether to treat with thyroid hormone replacement. To predict longer term prognosis of cases without thyroid hormone replacement, long term follow up of large number of patients is needed.
Diagnosis ; Female ; Follow-Up Studies* ; Humans ; Infant, Newborn* ; Male ; Medical Records ; Neonatal Screening ; Povidone ; Prognosis ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland

We studied the results in forty-three knees in thirty patients-three male and twenty seven femalewho had rheumatoid arthritis, osteoarthritis, traumatic arthritis and osteonecrosis in the knee and were treated by total knee joint replacement. The average age of the patients was 56.7 years. The results were anaysed after follow-ups ranging from one year to three years and seven months, average being 23.6 months. The assessment was made upon the knee rating system of the Hospital for Special Surgery; the results were excellent in 29 knees, good in 12, fair in one and poor in one. The improvement of the flexion contractures was significant (postoperative average 1.7 degrees compared with preoperative average 20.1 degrees). The postoperative active flexion ranged from 70 degrees to 140 degrees (mean 110.2 degrees). One knee had a deep wound infection. The radiological loosening demonstrated in three cases, two of them had incomplete, nonprogressive radiolucent line, being less than one millimeter in width in the tibial component, one who had a deep infection showed three millimeters radiolucent line.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Male ; Osteoarthritis ; Osteonecrosis ; Wound Infection

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.
Adult ; Male ; Female ; Humans

No abstract available.
Lymphohistiocytosis, Hemophagocytic*

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.
Disseminated Intravascular Coagulation* ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery* ; Pathology ; Purpura, Thrombotic Thrombocytopenic

Cyclin D1, a G1 cyclin, has been implicated in the oncogenesis of various types of malignancies via deregulation of cell cycles. Amplification of cyclin D1 as a part of 11q13 amplicon has been reported in lung cancer as well as a subset of carcinomas arising from various organs including breast, head and neck, and esophagus. In addition to its role as an oncogene, several recent studies have suggested that amplification is indicative of poor prognosis. In this study we examined the cyclin D1 protein expression in 102 consecutive cases of lung cancers using the microwave enhanced immunohistochemical staining method and correlated the data with the histologic subtype and grade, Ki-67 (MIB-1) labeling index, and survival. Nuclear positive staining was observed in 18 cases (18 %) of lung cancers. Although squamous cell carcinoma demonstrated a higher rate of expression (12 /58, 21%), three of 33 adenocarcinomas (9%) revealed overexpression and both adenocarcinoma and squamous cell carcinoma components within the adenosquamous carcinoma showed nuclear staining. There was no correlation between cyclin D1 overexpression and histologic grade, Ki-67 (MIB-1) labeling index, and survival. These observations indicate that cyclin D1 protein overexpression might be implicated in the oncogenesis of the various histologic types of non-small cell lung carcinomas but it has no usefulness as a prognostic marker.
Cyclin D1 ; Cyclins/*analysis ; Human ; Immunohistochemistry ; Lung Neoplasms/*chemistry/mortality/pathology ; Neoplasm Staging ; Oncogene Proteins/*analysis ; Support, Non-U.S. Gov't

Immunological effect of the extract (KM-110) from Korean mistletoe (Viscum album coloratum) was examined. Lymphocytes obtained from KM-110-administrated mice showed increased responsiveness to mitogens, concanavalin-A (Con.A) and lipopolysaccharide (LPS). In order to study cytokine induct ability of the KM-110, macrophages from the Balb/c mice were cultivated in the medium containing the extract. the macrophages were shown to induce secretion of tumor necrosis factor-alpha (TNF-alpha), interleukin 1 and 6 (IL-1, IL-6) and interferon-gamma (INF-gamma). We then tested antitumor activity of the macrophages activated by the KM-110. Peritoneal macrophages harvested from the KM110-treated Balb/c mice exhibited cytotoxicity against the syngeneic 3LL carcinoma cells. ...continue...
Animals ; Interferon-gamma ; Interleukin-1 ; Lymphocytes ; Macrophages ; Macrophages, Peritoneal ; Mice ; Mistletoe* ; Mitogens ; Tumor Necrosis Factor-alpha ; Viscum album* ; Viscum*