Background and Objectives: Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease. Methods: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. Results: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS).At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. Conclusions The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Giant cell arteritis (GCA) is an autoimmune vasculitic disorder of unknown origin. Systemic GCA causing cerebral infarction due to intracranial arteritis is rare. Early diagnosis and anti-inflammatory treatment of the GCA are necessary to prevent systemic involvement. A 66-year-old woman presented with dysarthria and left hemiparesis. A brain MRI showed ischemic lesions in the right temporoparietal area. We report a pathological case of GCA with clinical and neuroradiological evidence of cerebral infarction.
Aged ; Arteritis ; Brain ; Cerebral Infarction* ; Dysarthria ; Early Diagnosis ; Female ; Giant Cell Arteritis* ; Giant Cells* ; Humans ; Magnetic Resonance Imaging ; Paresis ; Pathology

BACKGROUND: This study was to evaluate the therapeutic efficacy of consolidation therapy based on intermediate dose Ara-C in patients with newly diagnosed acute myelogenous leukemia (AML) in Seoul National University Hospital. And also, this study was to assess the toxicities of the treatment. METHODS: We have reviewed retrospectively our experience of patients with newly diagnosed non-M3 AML between January 1993 and July 1997. They were treated with induction chemotherapy with Ara-C 200mg/m2/d over 24 h for 7 days and daunorubicin 45mg/m2/d daily for 3 days. The patients achieving complete remission (CR) are to receive the 3 courses of consolidation chemotherapy based on intermediate dose of Ara-C 1,000mg/m2 given over 2h every 12 h for a total of eight to ten doses. Patients having HLA-matched sibling donors with informed consent could receive allogeneic bone marrow transplantation (BMT). RESULTS: One hundred and fifteen patients were reviewed. The median age was 41 years (range, 16-69) and median follow-up was 75 months. The CR rate was 72.2%. The median disease-free survival (DFS) of patients receiving consolidation therapy and allogeneic BMT was 21 months and 26.5 months, respectively. The overall survival (OS) was 13 months for patients not-receiving consolidation therapy, 21 months for consolidation therapy, and 31 months for allogeneic BMT, respectively. The rate of treatment-related mortality of consolidation therapy was 14% and cause of all deaths was infection. But in allogeneic BMT, that mortality rate was 42%; 2 infections, 2 veno-occlusive diseases and 1 cyclophosphamide-induced cardiomyopathy. CONCLUSION: Patients receiving consolidation therapy with intermediate dose Ara-C had longer DFS and OS. But their DFS and OS was not superior to that of patients receiving allogeneic BMT. In addition, that result was inferior to that of patients receiving high dose Ara-C based consolidation therapy, compared with other previous studies. However, this study was retrospective and so further prospective study will be required for comparing different doses of Ara-C consolidation therapy versus BMT.
Adult* ; Bone Marrow Transplantation ; Cardiomyopathies ; Consolidation Chemotherapy ; Cytarabine* ; Daunorubicin ; Disease-Free Survival ; Follow-Up Studies* ; Humans ; Induction Chemotherapy ; Informed Consent ; Leukemia, Myeloid, Acute* ; Mortality ; Retrospective Studies ; Seoul ; Siblings ; Tissue Donors

BACKGROUND: Translocations involving the MLL gene on the long arm of chromosome 11 (11q23) are frequently observed in acute leukemia. The detection of this genetic change has a unique significance due to its implication for poor prognosis. The aim of this study was to determine the utility of fluorescence in situ hybridization (FISH) method in detecting the MLL translocation. METHODS: We applied both conventional cytogenetic analysis (CC) and MLL FISH on 289 consecutive Korean patients (children and adults) with acute leukemia and analyzed the data, placing an emphasis on the discrepancies in the results. RESULTS: Twenty-two of 289 patients (7.6%) had the 11q23/MLL translocation. In 9 cases of 22 (41%), only FISH detected the translocation. In 8 among 22 patients, a total of 19 follow-up examinations were performed, of which FISH detected a significant level of leukemia cells harboring the MLL translocation in 5 (26%) without cytogenetic evidence. Besides the MLL translocation, FISH detected submicroscopic amplification, partial deletion of the MLL gene, and trisomy 11 in 12 cases without cytogenetic evidence. CONCLUSIONS: These results demonstrate that up to 41% of the MLL translocations at initial workups and 26% during follow-up were detected by FISH without cytogenetic evidence. Thus, we recommend that MLL FISH should be performed in the diagnosis and monitoring of acute leukemia in combination with CC.
Arm ; Asian Continental Ancestry Group ; Chromosomes, Human, Pair 11 ; Cytogenetic Analysis ; Cytogenetics ; Diagnosis ; Fluorescence ; Follow-Up Studies ; Humans ; In Situ Hybridization ; Leukemia* ; Prognosis ; Trisomy

PURPOSE: It is important in asthmatic children to encourage ordinary physical activity. However physical activities in winter are limited excessively by their parents for fear of bronchospasm by cold air and exercise. Children's asthma camps help them to learn about asthma management, make new friends with other asthmatic children, have positive attitude about the disease and have a more active lifestyle. But there have been few asthma camps and appropriate asthma camp programs have not been developed in Korea. Our study was done to see how camp programs influenced on asthma patient by measuring of PEFR during camp programs and thereby to have the data be used for future development of asthma camp programs. METHODS: From January 19th to 22th 1998, we recruited for camp 17 asthmatic patients and 31 normal children who had no history of admission due to respiratory infection. The main camp programs consisted of skiing and sledding. PEFR was checked 5 times a day and we analyzed variation of PEFR in relation to daily activities, temperature, humidity of atmosphere. RESULTS: 1) The mean age was 8 years with a range of 5 years to 11 years with male predominance (male/female : 2.4/1) in asthma group and the mean age was 10 years with a range of 5 years to 16 years with female predominance (male/female: 1/2) in control group. 2) The mean PEFR (% predicted) was checked early morning, prior to breakfast, lunchtime, supper and at the end of the day's activities (before sleeping) were 90.43+/-24.15%, 93.48+/-19.42%, 98.99+/-25.89%, 96.77+/-21.23%, 100.9+/-20.86% in asthma group and 93.69+/-16.41%, 94.49+/-17.13%, 94.15+/-17.28%, 96.84+/-16.44%, 96.52+/-16.24% in control group. All values were within normal range and there was no significant change of the mean PEFR value in relation to daily activity. The values of PEFR were low at early morning. We have observed a significant difference of PEFR between early morning and before sleeping in asthma group (P<0.05). 3) In the asthma group, 2 cases had respiratory difficulty prior to lunchtime but symptoms were resolved after bronchodilator nebulization. CONCLUSION: We recommend ski or sledding to be safe as one of the programs for asthma camp but control of asthma attack is needed because lung function is decreased at night and appropriate warming up is needed before cold air sports.
Asthma ; Atmosphere ; Breakfast ; Bronchial Spasm ; Child ; Female ; Friends ; Humans ; Humidity ; Korea ; Life Style ; Lunch ; Lung ; Male ; Meals ; Motor Activity ; Parents ; Peak Expiratory Flow Rate ; Reference Values ; Skiing ; Snow Sports ; Sports

Combination chemotherapy and radiation therapy have contributed to the successful treatment of various cancer patients. But the development of second malignancies is an inevitable complication of long-term cytotoxic treatment. The most serious and frequent of such complications is acute myelogenous leukemia (AML). Therapy-related leukemia is generally fatal. Since the number of patients exposed to chemotherapy is increasing each year, the clinical significance of this entity cannot be underestimated. There have been many investigations of therapy-related leukemia, but in Korea published reports are rare. We describe four such cases, involving one older female with lung cancer and three children with acute lymphoblastic leukemia (ALL) and malignant lymphoma. Alkylating agents were used for chemotherapy, and in one case, topoisomerase II inhibitor. Irrespective of the causative agents, the latency periods were relatively short, and despite induction chemotherapy in two, all survived for only a few months. During the follow-up of patients treated for primary malignancies, the possibility of therapy-related leukemia should always be borne in mind.
Adolescence ; Aged ; Antineoplastic Agents, Alkylating/therapeutic use* ; Antineoplastic Agents, Alkylating/adverse effects ; Carcinoma, Small Cell/radiotherapy ; Carcinoma, Small Cell/drug therapy ; Case Report ; Child ; DNA Topoisomerase (ATP-Hydrolysing)/antagonists & inhibitors ; Fatal Outcome ; Female ; Human ; Leukemia, Lymphocytic, Acute, L1/drug therapy ; Leukemia, Monocytic, Acute/etiology ; Leukemia, Myelocytic, Acute/etiology* ; Leukemia, Myelomonocytic, Acute/etiology* ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/drug therapy ; Lymphoma, B-Cell/radiotherapy ; Lymphoma, B-Cell/drug therapy ; Male ; Neoplasms, Second Primary/etiology*

To investigate changes in the radiographic appearance during weight-bearing in hallux valgus and examine the significance of the weight-bearing view, a comparative study was performed. Both normal and hallux valgus patients, who were all women over forty years old were studied. We reviewed radiographs of 100 normal feet in 50 patients and 70 symptomatic hallux valgus feet in 40 patients. Dorsoplantar radiographs were taken during weight-bearing and nonweight-bearing. Quantifiable angles were identified on dorsoplantar films in both the weight-bearing and nonweight-bearing positions. The measured angles were the hallux valgus angle, intermetatarsal angles between the first and second metatarsals, the second and third metatarsals, the third and fourth metatarsals, the fourth and fifth metatarsals, the first and fifth metatarsals, and the second and fifth metatarsals, and the interphalangeal angle. The hallux valgus angles in both groups were not constant on weight-bearing, whereas the intermetatarsals angle between the first and second metatarsals in both groups increased significantly on weight-bearing. The results show that most of the changes thought to occur with weight-bearing cannot be consistently demonstrated. Obtaining a weight-bearing view may not be routinely indicated in all patients.
Female ; Foot* ; Hallux Valgus* ; Hallux* ; Humans ; Metatarsal Bones ; Weight-Bearing*

BACKGROUND: Immunologic marker studies and cytogenetic studies as well as morphological studies are frequently performed for the differential diagnosis of acute leukemia. We investigated the relationship of between immunophenotyping and cytogenetic abnormalities in acute myelogenous leukemias (AMLs). METHODS: Total 153 cases of AMLs were included. Morphological, cytochemical, immunophenotypic, and cytogenetic studies were performed. We classified the AML cases according to immunophenotyping and investigated the association between cytogenetic results and immunophenotype. And we compared differences between the AML group with lymphoid markers and that without them. RESULTS: In 153 cases of AMLs, lymphoid markers (CD2, CD5, CD7, CD19, CD10) were coexpressed in 59 cases (38.6%). Cytogenetic abnormalities were in 106 cases (69.3%). No significant difference in cytogenetic abnormalities was observed between the group with lymphoid markers and without them (76.3% vs. 64.9%, P>0.05). t(8;21)(q22;22) was significantly more frequent in CD19+AMLs (78.3% vs. 7.7%, P<0.0001), compared to CD19-AMLs. In CD2+AMLs, t(15;17)(q24;q21) was significantly more frequent than in CD2-AMLs (81.8% vs. 8.5%, P<0.0001). CD7+AML cases showed fewer cytogenetic abnormalities than AML with other lymphoid markers and various chromosomal abnormalities. CONCLUSIONS: In AML, cytogenetic abnormalities were different in relation to aberrant lymphoid markers. CD19 vs. t(8;21) and CD2 vs. t(15;17) were closely associated with each other. It is thought that CD7+AML cases are heterogeneous group. We need the study for response to therapy and prognosis in AMLs with lymphoid markers so that the data of this study can be helpful for the diagnosis and treatment.
Biomarkers ; Chromosome Aberrations* ; Cytogenetics* ; Diagnosis ; Diagnosis, Differential ; Humans ; Immunophenotyping ; Leukemia ; Leukemia, Myeloid, Acute* ; Prognosis

BACKGROUND: Rocuronium, a new nondepolarizing muscle relaxant, has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence induction of anesthesia. Therefore we have compared rocuronium with pancuronium and vecuronium about the onset time, intubation time, and tracheal intubating conditions. METHOD: Thirty patients were divided into three groups, who were receiving intravenously pancuronium 0.14 mg/kg, vecuronium 0.1 mg/kg and rocuronium 0.6 mg/kg respectively for tracheal intubation during induction of anesthesia. The onset time(Time from drug administration to zero count of PTC) and intubation time were checked using train of four responses of the adductor pollicis muscle after ulnar nerve stimulation(2 Hz, 40mA) every 10 seconds. The intubation conditions were recorded by a "blinded" assessor as excellent, good, fair or not possible. RESULT: The onset time of pancuronium, vecuronium and rocuronium was, 125.0+/-10.0, 256.0+/-18.4 and 90.0+/-22.1 sec. respectivly. The time of intubation was 94.0+/-12.6, 95.3+/-7.9, and 77.0+/-10.6sec.(pancuronium,vecuronium & rocuronium respectively). The onset time of rocuronium was significantly faster than the other two nondepolarizing muscle relaxants. The tracheal intubation with rocuronium was possible earlier than pancuronium or vecuronium but no statistical significance was observed and the condition of intubation was excellent compare to others in all ten patients. CONCLUSION: Rocuronium may have advantages over existing non-depolarizing neuromuscular blocking agents with faster rate of development of neuromuscular block with excellent intubation condition after administraction of a dose 0.6 mg/kg(ED 95 x 2).
Anesthesia ; Humans ; Intubation ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Ulnar Nerve ; Vecuronium Bromide

BACKGROUND: Rocuronium, a new nondepolarizing muscle relaxant, has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence induction of anesthesia. Therefore we have compared rocuronium with pancuronium and vecuronium about the onset time, intubation time, and tracheal intubating conditions. METHOD: Thirty patients were divided into three groups, who were receiving intravenously pancuronium 0.14 mg/kg, vecuronium 0.1 mg/kg and rocuronium 0.6 mg/kg respectively for tracheal intubation during induction of anesthesia. The onset time(Time from drug administration to zero count of PTC) and intubation time were checked using train of four responses of the adductor pollicis muscle after ulnar nerve stimulation(2 Hz, 40mA) every 10 seconds. The intubation conditions were recorded by a "blinded" assessor as excellent, good, fair or not possible. RESULT: The onset time of pancuronium, vecuronium and rocuronium was, 125.0+/-10.0, 256.0+/-18.4 and 90.0+/-22.1 sec. respectivly. The time of intubation was 94.0+/-12.6, 95.3+/-7.9, and 77.0+/-10.6sec.(pancuronium,vecuronium & rocuronium respectively). The onset time of rocuronium was significantly faster than the other two nondepolarizing muscle relaxants. The tracheal intubation with rocuronium was possible earlier than pancuronium or vecuronium but no statistical significance was observed and the condition of intubation was excellent compare to others in all ten patients. CONCLUSION: Rocuronium may have advantages over existing non-depolarizing neuromuscular blocking agents with faster rate of development of neuromuscular block with excellent intubation condition after administraction of a dose 0.6 mg/kg(ED 95 x 2).
Anesthesia ; Humans ; Intubation ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Ulnar Nerve ; Vecuronium Bromide