BACKGROUND/AIMS: Compared with metallic drug-eluting stents (DES), bioresorbable vascular scaffolds (BVS) may further improve long-term outcomes of percutaneous coronary intervention (PCI) in patients with coronary artery disease. We report our early experience with BVS in Korea. METHODS: We evaluated 105 consecutive patients with BVS implanted at Asan Medical Center, Korea between October 21, 2015 and June 3, 2016. Angiographic results, and in-hospital and 6-month clinical outcomes were assessed. RESULTS: A total of 134 BVS were implanted to treat 115 lesions. The mean age was 62 ± 10.5 years; 85 patients (81%) were males, 26 patients (25%) were presented with acute coronary syndrome. Among 115 lesions treated with BVS, 76 (66.1%) were B2/C type, 27 (23.5%) were bifurcation lesions, and four (3.5%) were chronic total occlusion. Pre-dilation and post-dilation using high-pressure non-compliant balloon was performed in 104 lesions (90.4%) and 113 lesions (98.2%), respectively. During the procedure, intravascular imaging was used for all patients (100%; intravascular ultrasound 89 and optical coherence tomography 40 patients). Device success rate was 100%. In-segment and in-scaffold acute again were 1.1 ± 0.6 and 1.3 ± 0.5 mm, respectively. Periprocedural myocardial infraction occurred in four patients (3.8%). No deaths, stent thrombosis, or urgent revascularizations occurred either during hospitalization or the follow-up period. CONCLUSIONS: In this single-center experience, implantation of BVS with intravascular imaging support was feasible and early clinical outcomes were excellent. Evaluation of long-term efficacy and safety of BVS and its feasibility in clinical use for a broader range of lesions is warranted.
Absorbable Implants ; Acute Coronary Syndrome ; Chungcheongnam-do ; Coronary Artery Disease* ; Coronary Vessels* ; Drug-Eluting Stents ; Endovascular Procedures ; Follow-Up Studies ; Hospitalization ; Humans ; Korea* ; Male ; Percutaneous Coronary Intervention ; Stents ; Thrombosis ; Tomography, Optical Coherence ; Ultrasonography

Smoking is the major risk factor for lung squamous cell carcinoma (SCC), although a small number of lung SCCs occurs in never-smokers. The purpose of this study was to compare 50 hotspot mutations of lung SCCs between never-smokers and smokers. We retrospectively reviewed the medical records of patients newly diagnosed with lung SCC between January 1, 2011 and December 31, 2013 in the Seoul National University Hospital. Formalin-fixed, paraffin-embedded tumor samples were used for analysis of hotspot mutations. Fifty cancer-related genes in never-smokers were compared to those in ever-smokers. Of 379 lung SCC patients, 19 (5.0%) were never-smokers. The median age of these 19 patients was 67 years (interquartile range 57–73 years), and 10 of these patients were women (52.5%). The incidence rates of stage I, II, III, and IV disease in this group were 26.4%, 5.3%, 31.6%, and 36.8%, respectively, and sequencing was performed successfully in 14 cases. In the 26 lung SCC tumor samples (12 from never-smokers and 14 from ever-smokers) sequenced using personal genome machine, the most common mutations were in TP53 (75.0%), RAS (66.7%), and STK11 (33.3%), but mutations were also found in EGFR, KIT, and PTEN. The distribution of hotspot mutations in never-smokers was similar to that in ever-smokers. There was no significant difference in overall survival between the 2 groups. The 50 hotspot mutations of lung SCC in never-smokers were similar to those of ever-smokers.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Female ; Genome ; Humans ; Incidence ; Lung Neoplasms ; Lung* ; Medical Records ; Retrospective Studies ; Risk Factors ; Seoul ; Smoke ; Smoking

Intramuscular Stimulation (IMS) is a refined technique of traditional oriental acupuncture, and IMS has proved effective for relieving chronic pain of a neuropathic origin. IMS is currently seen to be quite a safe procedure with minimal complications having been reported to date. Various complications have been documented for acupuncture, but few complications or adverse effects have been reported in relation to the relatively new technique of IMS. We report here on a case of cervical spinal epidural hematoma that manifested as a cause of delayed hemiparesis. The safety of this procedure in unpracticed hands seems to be questionable.
Acupuncture ; Chronic Pain ; Hand ; Hematoma ; Hematoma, Epidural, Spinal ; Paresis

Post-cardiac injury syndrome (PCIS) includes post-myocardial infarction syndrome and post-pericardiotomy syndrome. PCIS is usually observed 1~6 weeks after cardiac surgery or myocardial infarction, and rarely after pacemaker implantation, coronary perforation, pulmonary thromboembolism, or radio-frequency ablation. PCIS is characterized by a low-grade fever, pleuritic chest pain, myalgia, a pericardial friction rub, increased inflammatory markers, and pericardial and pleural effusions. Although the pathophysiology of PCIS is controversial, the presence of anti-heart antibodies has implicated an autoimmune response, which has been widely accepted. The treatment of PCIS includes nonsteroidal anti-inflammatory drugs and corticosteroids. Currently, intervention is being performed increasingly in complicated obstructive coronary artery disease, such as chronic total occlusion, long-segment obstructive lesion, and left main coronary artery disease. We report a very rare case of PCIS following coronary artery perforation during PCI.
Adrenal Cortex Hormones ; Antibodies ; Autoimmunity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels ; Fever ; Friction ; Infarction ; Myocardial Infarction ; Pleural Effusion ; Pulmonary Embolism ; Thoracic Surgery

We report here on an uncommon case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture, and treated by emergent right lobectomy. We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage.
Tomography, X-Ray Computed/*methods ; Rupture ; Peliosis Hepatis/complications/*radiography/surgery ; Necrosis ; Humans ; Hemorrhage/etiology/*radiography/surgery ; Female ; Adult

Infected aneurysm of the aorta is a rare but life-threatening condition. The traditional strategy for treating infected aortic aneurysms is open surgical repair with antibiotic therapy. Endovascular repair of infected aortic aneurysms has been performed only sporadically. Case: A 70-year-old man with a history of diabetes who presented with intermittent fever for one month was referred to our institution. Before admission, antibiotic treatment had been already started and on admission, his general condition was not critical. A CT scan showed two saccular aneurysms of the infrarenal abdominal aorta and a retroperitoneal inflammation including hematoma. No microorganism was identified on blood culture. On follow-up CT scan 15 days later, a further increase in aneurysmal diameter was detected and endovascular repair was performed by using Gore Excluder stent graft. The patient was recovered and discharged on hospital day 29. One month after discharge, the patient was readmitted due to chilling and fever. Abdominal CT showed a retroperitoneal abscess around the previously repaired aortic aneurysm. Surgical drainage was performed without reconstruction with extra-anatomical bypass or in situ replacement. Culture from the abscess revealed the growth of Klebsiella pneumoniae. The patient was discharged on postoperative day 31 and continues to be observed.
Abscess* ; Aged ; Aneurysm ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Drainage ; Fever ; Follow-Up Studies ; Hematoma ; Humans ; Inflammation ; Klebsiella pneumoniae ; Tomography, X-Ray Computed

Infected aneurysm of the aorta is a rare but life-threatening condition. The traditional strategy for treating infected aortic aneurysms is open surgical repair with antibiotic therapy. Endovascular repair of infected aortic aneurysms has been performed only sporadically. Case: A 70-year-old man with a history of diabetes who presented with intermittent fever for one month was referred to our institution. Before admission, antibiotic treatment had been already started and on admission, his general condition was not critical. A CT scan showed two saccular aneurysms of the infrarenal abdominal aorta and a retroperitoneal inflammation including hematoma. No microorganism was identified on blood culture. On follow-up CT scan 15 days later, a further increase in aneurysmal diameter was detected and endovascular repair was performed by using Gore Excluder stent graft. The patient was recovered and discharged on hospital day 29. One month after discharge, the patient was readmitted due to chilling and fever. Abdominal CT showed a retroperitoneal abscess around the previously repaired aortic aneurysm. Surgical drainage was performed without reconstruction with extra-anatomical bypass or in situ replacement. Culture from the abscess revealed the growth of Klebsiella pneumoniae. The patient was discharged on postoperative day 31 and continues to be observed.
Abscess* ; Aged ; Aneurysm ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Drainage ; Fever ; Follow-Up Studies ; Hematoma ; Humans ; Inflammation ; Klebsiella pneumoniae ; Tomography, X-Ray Computed

PURPOSE: Breast-conserving therapy (BCT) is a practical alternative to mastectomy for treating ductal carcinoma in situ (DCIS). We reviewed our experience for treating patients with DCIS of the breast to evaluate the outcome after performing breast-conserving surgery plus radiotherapy (BCS-RT). MATERIALS AND METHODS: Between January 1983 and December 2002, 25 patients with clinically or mammographically detected DCIS were treated by BCS-RT. One patient was diagnosed with bilateral DCIS. Thirteen cases (50%) had symptomatic lesions at presentation. All 26 cases of 25 patients underwent BCS such as lumpectomy, partial mastectomy or quadrantectomy. All of them received whole breast irradiation to a median dose of 50.4 Gy. Twenty-four cases (92.3%) received a boost to the tumor bed for a median total dose of 59.4 Gy. The median follow up period was 67 months (range: 38 to 149 months). RESULTS: Two cases (7.7%) experienced ipsilateral breast tumor recurrence (IBTR) after BCS-RT. The histology results at the time of IBTR showed invasive ductal carcinoma (IDC), and the median time to IBTR was 25.5 months. On the univariate analysis, there were no significant factors associated with IBTR in the DCIS patients. The three-year local recurrence free survival rate was 96.0% and the overall survival rate was 96.3%. CONCLUSION: After the treatment for DCIS, the IBTR rate in our study was similar to other previous studies. Considering that we included patients who had many symptomatic lesions, close or positive margins and less that complete early data, our result is comparable to the previous studies. We could not find the prognostic significant factors associated with IBTR after BCS-RT. A longer follow up period with more patients would be required to evaluate the role of any predictive factors and to confirm these short-term results.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental* ; Radiotherapy* ; Recurrence ; Survival Rate

BACKGROUND: Recently, the legal and ethical issues relative to euthanasia are becoming controversial in Korea. This study was designed to verify the differences of the attitudes on euthanasia between judicial apprentices and residents. METHODS: The questionnaire was conducted on the 35th-group of the judicial apprentices on March 24, 2004, and on the residents from April 2 to May 22, 2004. The respondents were 636 in total consisting of 460 judicial apprentices and 176 residents. RESULTS: Of the total 636 subjects, 373 (81.1%) of the judicial apprentices and 149 (84.7%) of residents agreed that allowing euthanasia is moral, without any significant difference (P>0.05). The number of residents was greater (59 people, 33.5%) than that of judicial apprentices (112 people, 24.4%) who agreed with active euthanasia (P<0.05). Among the total, 397 (86.3%) of the judicial apprentices and 160 (91.4%) of the residents answered that the law for euthanasia was necessary, without any significant difference (P>0.05). But, among these supporters, the respondents who agreed on active euthanasia were significantly different in number between judicial apprentices (n=93, 23.4%) and residents (n=54, 33.8%) (P<0.05). CONCLUSION: This study did not find any significant differences between the two groups in the necessity of the law for euthanasia, but the rate of agreement on active euthanasia was higher in residents group than in judicial apprentices group.
Surveys and Questionnaires ; Ethics ; Euthanasia* ; Euthanasia, Active ; Euthanasia, Passive ; Jurisprudence ; Korea