Risk Factors of the Atherosclerotic Peripheral Vascular Disease(PVD)

BACKGROUND: The main cause of atherosclerotic peripheral vascular disease is known to be atherosclerotic processing. In patients with atherosclerotic peripheral vascular disease, other atherosclerotic diseases are frequently combined, especially coronary artery disease. There were some suggestions that the risk factors of the atherosclerotic peripheral vascular disease be different from the those of the coronary artery disease. The aim of this study was to evaluate the independent risk factors for the atheroslerotic peripheral vascular disease(PVD) without influence of coronary artery disease(CAD). METHODS: The study population was male patients with atherosclerotic peripheral vascular disease(n=66) documented by peripheral angiogram form February 1991 to Octobor 1993, and during their abmission all patients with suspected atherosclerotic peripheral vascular diaease underwent both peripheral angiogram and coronary angiogram. Careful history taking and physical examination and lipid battery sampling after at least 14 hours of fasting were also performed. RESULTS: 60% of patients with peripheral vascular disease also had coronary artery disease. There was no significant difference in total cholesterol, HDL cholesterol, LDL cholestrerol, triglyceride between patients with peripheral vascular disease and age-matched control. The prevalence of hypertension was higher in patients with peripheral vascular disease but with no statistical significance. Smoking(p<0.0001) and diabetes(p<0.05) were strongly associated with peripheral vascular disease. When patients without coronary artery disease were compared to control from the viewpoint of risk factors again, the results were the same, that is, smoking and diabetes were also associated with periperal vascular diseaes. CONCLUSION: The prevalence of associated coronary artery disease was relatively high in patients with atherosclerotic peripheral vascular disease. And smoking and diabetes seem to be important risk factors of atherosclerotic peripheral vascular disease.

Predicting Factors of Multivessel Coronary Artery Disease in Dobutamine Stress Echocardiography

BACKGROUND: Dobutamine stress echocardiography(DSE) is useful detection of coronary artery disease as a noninvasive test. The purpose of this study is to find predicting factors of multivessel disease (MVD) in DSE. METHODS: Sixty-five patients suspicious of coronary artery disease excluding myocardial infarction on clinical base had undergone DSE and coronary arteriography. We divided the patient group into normal group (22 patients), single vessel disease(SVD) group(25 patients) and multivessel disease (MVD) group (18 patients) according to the findings of the findings of coronary angiogram. DSE findings and hemodynamic change during stress were analyzed and compared in these groups. We defined MVD on DSE as findings of new or aggravating regional wall motion abnormalities in 2 or more coronary artery territories, and significant stenosis on coronary angiogram as stenosis of 50% or more. RESULTS: 1) The numbers of diseased vessel evaluated by DSE showed significant correlation with those evaluated by coronary angiogram. 2) Resting, low-dose and peak-dose wall motion scores were significantly different among 3 groups, being higher in MVD group than in SVD and normal group. 3) Total administered dose of dobutamine in MVD group was significantly lower than that of normal group. 4) Heart rate at peak-dose showed significant difference among 3 groups, but product of heart rate and systolic blood pressure at peak-dose was not significantly different. 5) Frequency of ST segment change was significantly higher in multicessel disease group CONCLUSION: DSE reflects severity of coronary artery disease. and frequency of resting regional wall motion abnormally. wall motion score in low-dose and paak stress seems to be useful as a predictor of multivessel disease. Value of total administered dose of dobutamine, hemodynamic changes and ST segment changes as a MVD remains to be proved.

Predicting Factors of Multivessel Coronary Artery Disease in Dobutamine Stress Echocardiography

BACKGROUND: Dobutamine stress echocardiography(DSE) is useful detection of coronary artery disease as a noninvasive test. The purpose of this study is to find predicting factors of multivessel disease (MVD) in DSE. METHODS: Sixty-five patients suspicious of coronary artery disease excluding myocardial infarction on clinical base had undergone DSE and coronary arteriography. We divided the patient group into normal group (22 patients), single vessel disease(SVD) group(25 patients) and multivessel disease (MVD) group (18 patients) according to the findings of the findings of coronary angiogram. DSE findings and hemodynamic change during stress were analyzed and compared in these groups. We defined MVD on DSE as findings of new or aggravating regional wall motion abnormalities in 2 or more coronary artery territories, and significant stenosis on coronary angiogram as stenosis of 50% or more. RESULTS: 1) The numbers of diseased vessel evaluated by DSE showed significant correlation with those evaluated by coronary angiogram. 2) Resting, low-dose and peak-dose wall motion scores were significantly different among 3 groups, being higher in MVD group than in SVD and normal group. 3) Total administered dose of dobutamine in MVD group was significantly lower than that of normal group. 4) Heart rate at peak-dose showed significant difference among 3 groups, but product of heart rate and systolic blood pressure at peak-dose was not significantly different. 5) Frequency of ST segment change was significantly higher in multicessel disease group CONCLUSION: DSE reflects severity of coronary artery disease. and frequency of resting regional wall motion abnormally. wall motion score in low-dose and paak stress seems to be useful as a predictor of multivessel disease. Value of total administered dose of dobutamine, hemodynamic changes and ST segment changes as a MVD remains to be proved.

Clinical Observation on Reconstruction of the Anophthalmic Contracted Socket in 28 Eyes

Reconstruction of the anophthalmic contracted socket was performed in 28 eyes (34 cases) from October 1981 to February 1985. The follow-up period after surgery ranged from 6 months to 12 months. The age range of the patients was from 5 years to 60 years, and there were 25 males and 3 females. Degree of the contraction and method of the operation were as follows: 1. Mildly contracted socket. Among 12 eyes, 7 eyes were operated with acrylic conformer(AC) after buccal mucous membrane graft(BMMG) and 5 eyes with dental conformer(DC) after buccal mucous membrane graft. 2. Moderately contracted socket. Among 9 eyes, 6 eyes were operated with AC after BMMG and 3 eyes with DC after BMMG. 3. Severely contracted socket. Among 7 eyes, 5 eyes were operated with AC after BMMG and 2 eyes with DC after BMMG. The results were as follows: 1. Etiology of the contracted socket was inflammation(12 eyes: 43%), trauma(7 eyes: 25%), burn(5 eyes: 18%) and irradiation(4 eyes: 14%). 2. In reconstruction of the contracted socket, buccal mucosa was a good substitute for conjunctiva. 3. Better result was obtained in the cases with lesser contraction preoperatively, and in the cases of reconstruction after preoperative repair of lid defect. 4. The optimal interval for further surgery was at least about 6 months due to resolution of the fibroblastic activity. 5. Postoperative complications were noted in 8 cases(24%), which were recontraction in 4 cases(12%), shrinkage of the graft in 2 cases(6%), necrosis of the graft in 1 case(3%), and infection in 1 case(3%). 6. Most patients now wear artificial eyes with or without lightly tinted glasses, giving them good appearance, even though their sight was gone.