Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand DrugEluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0–3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63–1.24), all-cause death (HR, 0.87; 95% CI, 0.60–1.25), and MI (HR, 1.25; 95% CI, 0.49–3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/ or revascularization (HR, 0.38; 95% CI, 0.14–0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

PURPOSE: Chlormadinone acetate (CMA) therapy for benign prostatic hyperplasia (BPH) may lower the serum prostate specific antigen (PSA) level. However, little is known about the effect of CMA on the total or free serum PSA levels of PSA. Such information would be important since PSA testing is useful for prostate cancer screening. Thus, we prospectively studied the effect of CMA therapy on the total and free serum PSA levels. MATERIALS AND METHODS: The patients with lower urinary tract symptoms (LUTS) and BPH who were aged over 50 years were treated with 50mg CMA for 6 months. Men with a PSA level greater than 10ng/ml were excluded to reduce the likelihood of including cases of occult prostate cancer. Those with suspicious findings on the digital rectal examination and serum PSA testing were biopsied to rule out prostate cancer. alpha- blocking agents were permitted to treat the men with LUTS. Serum levels of the total and free PSA were measured at the study baseline and after approximately 3 and 6 months. The prostate volume (PV) was assessed by transrectal ultrasonography. RESULTS: The analysis included 170 patients with a mean age of 67.9 years, a baseline PV of 47.3ml and a baseline total PSA of 4.1ng/ml. The total PSA levels declined from 4.1ng/ml at baseline to 2.0ng/ml after 6 months of treatment (50.7% decrease, p<0.01). The mean percent free PSA (21% to 22% at baseline) was not significantly altered by CMA treatment. The PSA levels and PV at baseline did not affect the rate of decline of PSA. CONCLUSIONS: The total PSA serum levels decreased by an average of 50% during CMA therapy, but the percent free PSA did not change significantly. This information is potentially useful in the interpretation of the PSA data that's used for early detection of prostate cancer in the men receiving CMA.
Chlormadinone Acetate* ; Digital Rectal Examination ; Humans ; Lower Urinary Tract Symptoms ; Male ; Mass Screening ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Ultrasonography

OBJECTIVES: To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.
Aged* ; Busan* ; Cognition Disorders* ; Dementia* ; Female ; Humans ; Male ; Prevalence* ; Psychometrics

PURPOSE: To clarify the morphologic and quantitative changes of mechanoreceptors of the human ACL with degenerative arthritis. MATERIALS AND METHODS: Eleven fresh specimens of anterior cruciate ligament (ACL) were obtained from patients with degenerative arthritis during TKA. As a control, two fresh specimens were taken from healthy men at the time of a traumatic above knee amputation. The whole ligaments were serially frozen and sectioned at a thickness of 40 mum. After immunohistochemical staining, the mechanoreceptors were observed under a light microscope. The ratios of sections showing mechanoreceptors were calculated. Statistical analyses were performed using the chi-square test. RESULTS: In the two control specimens, nineteen mechanoreceptors were found, evenly distributed at the femoral and tibial ends. However, the average number of mechanoreceptors was 1.4 (total 15) in the arthritic ligaments (p<0.05), and these were located near the femoral side rather than the tibial end. The percentage of sections showing mechanorecptors was 8.3% in the arthritic group and 40.2% in the control group (p<0.05). All receptors were round or fusiform shaped Ruffini corpuscles; Pacinian corpuscles could not be found in either group. Nine of 15 mechanoreceptors in the arthritic groups were "necrotic" in shape. CONCLUSION: Mechanoreceptors in arthritic ACL were significantly reduced in number and mainly necrotic in shape. Our findings suggest that the numerical and morphological changes of mechanoreceptors are closely related with reduced proprioception in degenerative arthritis.
Amputation ; Anterior Cruciate Ligament* ; Humans ; Knee ; Ligaments ; Male ; Mechanoreceptors* ; Osteoarthritis* ; Pacinian Corpuscles ; Proprioception

BACKGROUND: Recent studies showed that non-steroidal antiinflammatory drug may reduce the risk of colorectal cancers. So its potential target, cyclooxygenase (COX)-2 in colorectal cancers has been widely investigated. However, the rate and patterns of COX-2 expression in colorectal polyps have been quite variable among study groups. Furthermore, its role has not been established. The study aim is to investigate the expressions of COX-2 and vascular endothelial growth factor (VEGF) and to evaluate the role of COX-2 in colorectal polyps. METHODS: Fifty-seven colorectal polyps from endoscopic polypectomy or surgical resection were enrolled. Polyps were as follows; 9 were hyperplastic polyps, 14 mild, 26 moderate dysplasia, 8 high grade adenomas (5 severe dysplasia, a carcinoma in situ, and two intramucosal carcinomas). They were stained for COX-2 and VEGF by immunohistochemistry. The intensity of staining according to histologic grades and size of polyp was semi-quantitatively assessed. RESULTS: COX-2 was expressed in 18 cases (31.8%) by dysplastic epithelium and 29 cases (50.9%) by interstitial cells. Epithelial COX-2 expressions were significantly related to histologic grades and size, and begun at moderate dysplasia actually. Interstitial COX-2 was little related to histologic grades and size. VEGF was expressed in 35 cases (61.4%). There was close relationship between epithelial COX-2 and VEGF expressions. CONCLUSION: COX-2 is expressed both in dysplastic epithelium and interstitial cells of colorectal polyps. Our results suggest that epithelial COX-2 expression may be playing a role in tumorigenesis of colorectal polyp, possibly involved in angiogenesis with VEGF.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Colorectal Neoplasms ; Cyclooxygenase 2* ; Endothelial Growth Factors ; Epithelium ; Immunohistochemistry ; Polyps* ; Prostaglandin-Endoperoxide Synthases ; Vascular Endothelial Growth Factor A*

Hemangiopericytomas is a rare malignant tumor of the central nervous system having an incidence of 1-3.8% of all primary intracranial meningeal tumors, and the occurrence of cystic hemangiopericytomas is even rarer. We report our recent experience of a case of cerebral hemangiopericytoma associated with a large cyst in a 38 year-old man. The patient presented with 1-month history of headache. Computerized tomography(CT) and magnetic resonance image(MRI) showed a huge-sized, cystic tumor in the left frontal region. Histopathological report of the excised tumor confirmed cystic hemangiopericytoma. Over the years, the issue of classifying hemangiopericytoma as a form of meningioma has been controversial. Since hemangiopericytoma differs from that of ordinary meningiomas because of its extremely malignant behavior and different histological and ultrastructural properties, the author suggest that hemangiopericytoma classified not with meningiomas. Regardless of classification, total surgical removal of this tumor is crucial due to its tendency for local recurrence despite aggressive resection.
Adult ; Central Nervous System ; Classification ; Headache ; Hemangiopericytoma* ; Humans ; Incidence ; Meningeal Neoplasms ; Meningioma ; Recurrence

Granulocytic sarcoma(chloroma) is an uncommon and solid tumor composed of immature cells of the mycloid series usually seen during the course of myelogenous leukemia or myeloproliferative disorders. The common sites for the occurrence of granulocytic sarcoma are soft tissue, periosteum, bone, lymphoid tissue, skin, gastrointestinal tract and testis. But extradural presentation of the spine is very rare. We report two cases of extradural granulocytic sarcoma of the spine. Early recognition of the etiology of the paraplegia and the underlying systemic involvement with leukemia resulted in an excellent neurological and hematological outcome.
Gastrointestinal Tract ; Leukemia ; Leukemia, Myeloid ; Lymphoid Tissue ; Myeloproliferative Disorders ; Paraplegia ; Periosteum ; Sarcoma, Myeloid* ; Skin ; Spine* ; Testis

Author reviewed the 31 cases of multiple intracranial aneurysms clinically from January 1981 to July 1987, at Inje College Busan Paik Hospital. The results obtained were as follows: 1) The incidence of multiple intracranial aneurysm was 7.8%. In most cases(94%), the number of aneurysm was two. 2) Approximately over 70% of patients were 6th and 7th decades, male to female ratio was 1:3.4. 3) The location of multiple intracranial aneurysms was in order, on the opposite side(39%), on the same side(26%), one in the midline and one on the side(29%). The location of indivisual aneurysms was in order, P-com. A(36%), MCA(25%), A-com. A(17%), ICA(13%). 4) The site of the ruptured aneurysm was determined by CT finding(55%), focal mass effect and spasm in angiography(29%), and others. The accurary was 97%. The possibility of rupture at each location was A-com. A(73%), P-com. A(57%), ICA(38%), MCA(31%). 5) 12 cases among them were treated with one-stage operation and 9 cases with two-stage operation. The post-operative favorable outcome was estimated in 13 cases(54%), the surgical mortality was 13%. There was no statistical difference between two groups.
Aneurysm ; Aneurysm, Ruptured ; Busan ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Rupture ; Spasm

Author reviewed the 31 cases of multiple intracranial aneurysms clinically from January 1981 to July 1987, at Inje College Busan Paik Hospital. The results obtained were as follows: 1) The incidence of multiple intracranial aneurysm was 7.8%. In most cases(94%), the number of aneurysm was two. 2) Approximately over 70% of patients were 6th and 7th decades, male to female ratio was 1:3.4. 3) The location of multiple intracranial aneurysms was in order, on the opposite side(39%), on the same side(26%), one in the midline and one on the side(29%). The location of indivisual aneurysms was in order, P-com. A(36%), MCA(25%), A-com. A(17%), ICA(13%). 4) The site of the ruptured aneurysm was determined by CT finding(55%), focal mass effect and spasm in angiography(29%), and others. The accurary was 97%. The possibility of rupture at each location was A-com. A(73%), P-com. A(57%), ICA(38%), MCA(31%). 5) 12 cases among them were treated with one-stage operation and 9 cases with two-stage operation. The post-operative favorable outcome was estimated in 13 cases(54%), the surgical mortality was 13%. There was no statistical difference between two groups.
Aneurysm ; Aneurysm, Ruptured ; Busan ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Rupture ; Spasm

The importance of the ticks in medical field has been emphasized because of their association with and transmission of various diseases. We report herein a case of tick bite in a 55-year-old male farmer, who visited our hospital on July 2, 1981 with a parasite attached on right lower flank and rice to small pea sized, pruritic erythematous papular skin eruptions on chest and right lower flank. The skin lesions disappeared completely with.in five days after removal of the parasite, which was identified with an adult female tick which belongs to Genus Ixodes.
Adult ; Female ; Humans ; Ixodes* ; Male ; Middle Aged ; Parasites ; Peas ; Skin ; Thorax ; Tick Bites* ; Ticks*