Development of Species-Specific PCR Primers for the Detection of Streptococcus sobrinus

This study was undertaken to develop species-specific forward and universal reverse PCR primers for the detection of Streptococcus sobrinus. These primers target the variable regions of the 16S ribosomal RNA coding gene (rDNA) and their specificity was tested against 10 strains of S. sobrinus strains and 20 different species of oral bacteria using serial dilutions of the purified genomic DNA of S.sobrinus ATCC 33478T . Our data show that species-specific amplicons were obtained from all the S. sobrinus strains tested but not from other species. Both direct and nested PCR could detect as little as 400 pg and 4 fg of genomic DNA from S. sobrinus ATCC 33478T , respectively. This result suggests that these PCR primers are highly specific and sensitive and applicable to the detection of S. sobrinus.

Effect of alginate on early bone healing after implantation of particulate dentin and plaster of paris mixture

0.05), nor were the differences between the two experimental groups at 4 and 8 weeks. In comparison with the control group, however, both experimental groups showed superior new bone formation. Although the difference between the two experimental groups was not statistically significant, a tendency for superior new bone formation was detected with the combination of particulate dentin, plaster of Paris, and alginate. Furthermore, more fusion of woven bone and bony trabeculae formation occurred in this group, suggesting that oligosaccharides play a role in the formation and maturation of new bone. In conclusion, the treatment of bone defects by grafting with a mixture of particulate dentin and plaster of Paris alone or with alginate significantly improved the formation of new bone, both quantitatively and qualitatively. The oligosaccharide treatment appeared to improve the formation of new bone quantitatively and qualitatively.

Molecular identification of bacteria from osteomyelitis of the jaws

The purpose of this study was to isolate and identify the bacteria in osteomyelitis lesion of 3 patients. Two lesions were due to the postinfection after extraction. The other was resulted from mal-fixation of both sides of mandibular angles. Pus samples were collected by needle aspiration from the lesion and examined by culture method. Bacterial culture was performed in three culture systems (anaer-obic, CO2, and aerobic incubator). Identification of the bacteria was performed by 16S rRNA gene cloning and nucleotide sequencing method. Our results showed that Streptococci species was predominantly isolated in both lesions of extraction socket. Only one species (Proteus vulagris) was detected in lesion of mandibular angle. This study was not sufficient to identify the causative bacteria in those osteomyelitis. However, our data may be offered the clue to solve the problem.

Angiographic Outcomes and Predictors of Recurrent Restenosis after Cutting Balloon Angioplasty for the Treatment of In-Stent Restenosis

BACKGROUND AND OBJECTIVES: The optimal treatment for in-stent restenosis(SR) s controversial, although intracoronary radiation therapy(CRT) as provided the most consistent results to date. This study was designed to assess the early and late angiographic results, and to find independent predictors of recurrent restenosis, following cutting balloon angioplasty(BA) or ISR. SUBJECTS AND METHODS: Eighty patients(7 lesions) ith first time ISR underwent CBA and systematic follow-up(U) ngiography. A conventional balloon was used before, or after, the CBA, if required. ICRT was used in 18 lesions(1%). A multivariate logistic regression analysis was performed.(why?) RESULTS: he ISR was focal(n=2, 37%), diffuse or proliferative(n=1, 58%) nd occlusive(n=4, 5%). Procedural success was achieved in all 87 lesions(00%). No significant edge dissection occurred. The pre- and post-procedural diameter stenoses(S) ere 81.5+/-10.8% and 6.7+/-6.0%, respectively, and the pre- and post-procedural MLD(efine MLD?) .71+/-0.44 mm and 2.85+/-0.32mm, respectively, with 2.14+/-0.44mm of acute gain. A FU angiography was performed in 54(8%) f the 69 lesions treated with CBA alone. The overall angiographic restenosis rate was 24%(3/54), with 9%(/22) n the focal ISR and 34%(1/32) n the diffuse or occlusive ISR. The FU DS and MLD were 32.0+/-23.4% and 2.1+/-0.7mm, respectively, with 0.79+/-0.69mm of late loss. The length of a restenotic lesion(R 12.2, 95% CI:1.3-115.2, p=.0286) as an independent predictor of recurrent restenosis. CONCLUSION: CBA is a simple and efficient first line treatment for ISR, with an acceptable restenosis rate, and the length of a restenotic lesion is an independent predictor of recurrent restenosis. In diffuse or occlusive ISR, more definite treatment modalities, such as ICRT combined with CBA or debulking techniques, might be required to reduce recurrent restenosis.

Histopathologic changes of the craniomandibular joint according to the amount of distraction after 6 weeks of distraction osteogenesis in rabbits

The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5mm, articular changes, especially, in the contralateral side should also be noted.

Acute myocardial infarction accompanying occlusion of left anterior descending and right coronary arteries / 대한내과학회지

Acute myocardial infarction (AMI) with simultaneous occlusion of two or three coronary arteries is extremely rare, but may cause devastating events unless immediate revascularization strategies are undertaken. We report an unusual case of AMI with ST-segment elevation in precordial leads. Thrombolysis was achieved successfully 2 hours after the onset of chest pain. Coronary angiography revealed residual heavy fresh thrombi at right coronary artery (RCA) as well as patent residual stenosis at left anterior descending coronary artery (LAD). Akinesia was demonstrated at anterolateral, apical, diaphragmatic, and posterobasal segments on left ventriculography. Large perfusion defects were proven at LAD and RCA territories on myocardial SPECT.

Age and Gender Distribution of Patients with Acute Myocardial Infarction Admitted to University Hospitals during the Period of 1990-1999

BACKGROUND AND OBJECTIVES: The prevalence of coronary disease in Korea, with the consequent morbidity and mortality, has rapidly risen during the last two decades. This study aimed to describe the changing pattern in the demographic composition during the 1990s of patients presenting with acute myocardial infarction (AMI) in Korean metropolitan cities. SUBJECTS AND METHODS: Data from the medical record of patients with AMI, admitted to five University Hospitals in Busan and Daegu between January 1990 and December 1999, were sorted according to their age (75 years) and gender. RESULTS: During the last decade, the number of cases of AMI increased from 283 in 1990, to 988 by 1999 (ratio of AMI/medical patients admitted; 1.68% in 1990 to 2.52% in 1999). The most prevalent age group was 6074 yrs (46.1%), followed by 4559 yrs (34.2%). Generally, the male cases were twice as prevalent as female (68.2% : 31.8%), but the gender ratio was reversed in the highest age group (>75 yrs) (44.6% : 55.4%). During the period in question, the gender ratio and age distribution remained reasonably constant throughout. The proportion of younger AMI patients (<45 yrs) did not increase. CONCLUSION: Admissions due to AMI increased substantially during the 1990s. Almost half the cases were from the 6074 yrs age group, and two third were male. There were little changes in the compositions of age and gender of the AMI cases during this period.

Comparison of Tissue Perfusion Measured by ST Segment Resolution between Thrombolysis and Primary Stenting in Acute ST Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVES: The primary objective of reperfusion therapy in the acute ST elevation myocardial infarction (STEMI) is the recovery of myocardial perfusion in infarct tissue, as well as the restoration of epicardial blood flow. ST segment resolution on the ECG is an index, which represents adequate myocardial tissue perfusion following treatment. SUBJECTS AND METHODS: Patients with acute STEMI, arriving within 12 hours of the onset of symptom underwent either thrombolysis (n=40) or primary stenting (n=51) were used for this study. ST segments on the ECG were measured with hand-held electronic callipers and the results were analysed by a single observer. RESULTS: Thrombolysis therapy was started earlier than primary stenting, although this was not statistically significant (311+/-171 minutes vs 399+/-251 minutes, p=0.61). After treatment, thrombolysis achieved a higher rate of complete ST segment resolution (>or=70%) compared to primary stenting (20/40;50.0% vs 13/51;25.4%, p=0.016). However, when the data was corrected for time, the difference between the two modalities was not significant (p=0.119). ST segment resolution varied significantly (p=0.026) according to treatment time, regardless of treatment modality. At the 6 month follow up, patients with complete ST segment resolution had a lower rate of major cardiac event (2.1% vs 13.8% p=0.094). CONCLUSION: In this study, thrombolysis achieved a higher rate of complete ST resolution compared with primary stenting in acute STEMI. By ad hoc analysis, this result was attributed to the difference in treatment time between the two groups, suggesting successful tissue reperfusion in acute STEMI is determined primarily by the rapidity, rather than the type, of treatment.

Plasma Homocysteine Concentration and Genotype Variation of Enzymes as Risk Factors in Patients with Coronary Artery Disease

BACKGROUND AND OBJECTIVES: Increased plasma homocysteine(tHcy) has been implicated as an independent risk factor for coronary artery diseas(CAD), but the relationship has not been firmly established. Present study aimed to determine the difference of plasma homocysteine between patients with CAD and normal control, and to identify the relation between plasma homocysteine and genotype variation of its metabolic enzymes, and serological characteristics. METHODS: Plasma homocysteine, fasting and post-methionin loading, folate and vitamin B12 were measured among 149 patients and 80 control subjects. Both group consisted of those younger than 65 years. Frequencies of prevalent mutations of enzymes involved in homocysteine metabolism, cytosine to thymidine transition (C(677)T) of methylentetrahydrofolate reductase (MTHFR) was determined by polymerase chain reaction (PCR) in 85 patients and 47 control. RESULT: There was no significant difference in homocysteine level between patients and control group (fasting tHcy; 10.4 +/- 3.6 vs 11.4 +/- 8.4 ng/ml, post-methionine loading tHcy; 18.8 +/- 4.9 vs 17.2 +/- 9.5 ng/ml, p> 0.05 respectively). Genotype frequency of MTHFR C(677)T was similar between two groups. Plasma homocysteine level did not appear to vary with genotypes of MTHFR both in patients and control subjects. Multiple linear regression analysis identified smoking as the most significant factor affecting plasma homocysteine level, followed by age, MTHFR genotype, obesity, and folate level. CONCLUSION: Homocysteine concentration was not different between controls and patients with CAD. Significant variation of homocysteine level according to genetypic polymorphism of metabolism enzymes was not observed. On multiple linear regression, several factors were identified to be related to homocysteine level, including MTHFR genotype. Further study is warranted to clarify the significance of homocysteine in the development of CAD.

Usefulness of Deep Seating Technique for Transradial Coronary Intervention

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.

Usefulness of Deep Seating Technique for Transradial Coronary Intervention

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.

Outpatient Cardiac Catheterization and Angiography: Safety and Experience with Transradial Approach

BACKGROUND AND OBJECTIVES: The safety and efficacy of outpatient cardiac catheterization was established. We evaluated our patient population and complications selected for outpatient procedures and our experience with transradial approach. MATERIALS AND METHODS: A total of 346 outpatient cardiac catheterization (31% of all diagnosticprocedures),performed with transradial approach, was compared with 788 in patient diagnostic procedures in terms of patient population, clinical and angiographic features, complications of examinations. RESULTS: 1) Indications of outpatient coronary angiography were as follows: follow-up of coronary interventions or bypass surgery (41.6%), recent-onset or aggravated angina (31.2%), atypical chest pain (19.4%), stable angina (3.8%), recent myocardial infarction (2.9%), variant angina (0.9%), preoperative evaluation of valvular or congenital heart disease (0.3%). 2) Significant coronary lesions were found in 216 (62.5%) patients and left main disease in 1 2 (3.5%). Coronary spasm test, internal mammary artery or saphenous vein graft angiography, aorto-ileofemoral angiography, and bilateral carotid angiography were safely performed as indicated. 3) Success rate of examination by primary approach was 94.5%, similar to 94.9% of inpatients. Alternative brachial or femoral approaches were needed in 19 (5.5%) patients. 4) No death, cerebral thromboembolism or myocardial infarction were observed and one-day admission was required in 13 (3.7%) patients. Initial 254 patients (33%) showed good radial pulse (94%), weak or absent radial pulse (6%), abnormal reverse Allen test (6%) up to 61+/-25 days. However, no claudication was observed. CONCLUSION: Cardiac catheterization and angiography was safely performed in the outpatient population selected using much extended inclusion criteria. Transradial approach is useful to set up outpatient procedures with less facilities and personnels and makes it available in the daytime with low readmission rate.

Evaluation of Left Internal Mammary Artery during Right Transradial Coronary Angiography: A New, Fast and Reliable Technique

BACKGROUND: The technique to evaluate left internal mammary artery (LIMA) is not well established during right transradial coronary angiography. MATERIALS AND METHODS: Following coronary angiography via right radial artery, LIMA angiography was performed using 5 French (F) Judkins JL-3.5 catheter in 110 patients (56+/-9 years [range: 46-81], 77 males). Eleven (10%) patients had grafted LIMAs. Subclavian and innominate arteries were moderately tortuous in 14 (13%) patients and aortic arches elongated and more vertically oriented in 16 (15%). The catheter, standing in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. After the tip portion was adjusted, contrast material was injected while sphyngomanometer cuff inflation applied to the left upper arm. RESULTS: Nonselective LIMA angiography was successfully performed in 108 (98%) patients. The catheter was engaged in the subclavian artery in a mean of 11+/-8 seconds (range: 3-136) from the time when the catheter was withdrawn from the ascending aorta. The image quality of LIMA was satisfactory in 103 (95%) patients and not satisfactory in 5 (5%) in whom the catheter tip was not placed near the origin of LIMA. In ten (91%) of the 11 patients with grafted LIMA, the anastomosis site and distal coronary vessels were well visualized. There were no complications, including arterial dissection and thromboembolism. CONCLUSION: Nonselective technique using 5 F Judkins JL-3.5 catheter is easy, fast, safe and reliable for evaluating LIMA during right transradial coronary angiography.

Outpatient Cardiac Catheterization and Angiography: Safety and Experience with Transradial Approach

BACKGROUND AND OBJECTIVES: The safety and efficacy of outpatient cardiac catheterization was established. We evaluated our patient population and complications selected for outpatient procedures and our experience with transradial approach. MATERIALS AND METHODS: A total of 346 outpatient cardiac catheterization (31% of all diagnosticprocedures),performed with transradial approach, was compared with 788 in patient diagnostic procedures in terms of patient population, clinical and angiographic features, complications of examinations. RESULTS: 1) Indications of outpatient coronary angiography were as follows: follow-up of coronary interventions or bypass surgery (41.6%), recent-onset or aggravated angina (31.2%), atypical chest pain (19.4%), stable angina (3.8%), recent myocardial infarction (2.9%), variant angina (0.9%), preoperative evaluation of valvular or congenital heart disease (0.3%). 2) Significant coronary lesions were found in 216 (62.5%) patients and left main disease in 1 2 (3.5%). Coronary spasm test, internal mammary artery or saphenous vein graft angiography, aorto-ileofemoral angiography, and bilateral carotid angiography were safely performed as indicated. 3) Success rate of examination by primary approach was 94.5%, similar to 94.9% of inpatients. Alternative brachial or femoral approaches were needed in 19 (5.5%) patients. 4) No death, cerebral thromboembolism or myocardial infarction were observed and one-day admission was required in 13 (3.7%) patients. Initial 254 patients (33%) showed good radial pulse (94%), weak or absent radial pulse (6%), abnormal reverse Allen test (6%) up to 61+/-25 days. However, no claudication was observed. CONCLUSION: Cardiac catheterization and angiography was safely performed in the outpatient population selected using much extended inclusion criteria. Transradial approach is useful to set up outpatient procedures with less facilities and personnels and makes it available in the daytime with low readmission rate.

Evaluation of Left Internal Mammary Artery during Right Transradial Coronary Angiography: A New, Fast and Reliable Technique

BACKGROUND: The technique to evaluate left internal mammary artery (LIMA) is not well established during right transradial coronary angiography. MATERIALS AND METHODS: Following coronary angiography via right radial artery, LIMA angiography was performed using 5 French (F) Judkins JL-3.5 catheter in 110 patients (56+/-9 years [range: 46-81], 77 males). Eleven (10%) patients had grafted LIMAs. Subclavian and innominate arteries were moderately tortuous in 14 (13%) patients and aortic arches elongated and more vertically oriented in 16 (15%). The catheter, standing in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. After the tip portion was adjusted, contrast material was injected while sphyngomanometer cuff inflation applied to the left upper arm. RESULTS: Nonselective LIMA angiography was successfully performed in 108 (98%) patients. The catheter was engaged in the subclavian artery in a mean of 11+/-8 seconds (range: 3-136) from the time when the catheter was withdrawn from the ascending aorta. The image quality of LIMA was satisfactory in 103 (95%) patients and not satisfactory in 5 (5%) in whom the catheter tip was not placed near the origin of LIMA. In ten (91%) of the 11 patients with grafted LIMA, the anastomosis site and distal coronary vessels were well visualized. There were no complications, including arterial dissection and thromboembolism. CONCLUSION: Nonselective technique using 5 F Judkins JL-3.5 catheter is easy, fast, safe and reliable for evaluating LIMA during right transradial coronary angiography.

Quadricuspid Aortic Valve: Report of Two Cases

Quadricuspid aortic valve is an uncommon congenital anomaly and cause of aortic regurgitation. We report two cases of quadricuspid aortic valve with aortic regurgitation. Case 1, a 51-year-old woman was admitted to our hospital for fatigue and chest tightness. She had to and fro murmur along the left sternal border. Transthoracic echocardiography and transeso- phageal echocardiography showed grade 2-3 aortic regurgitation with quadricuspid aortic valve. The aortic valve consisted of four cusps of equivalent size(Hurwitz type a). Case 2, a 35-year-old man was admitted to our hospital for exertional dyspnea and chest tightness. He had grade 4/6 to and fro murmur along the left sternal border. Transthoracic echocardiography showed grade 4 aortic regurgitation with suggested quadricuspid aortic valve. The aortic valve consisted of two equal larger cusps and two equal smaller cusps and a supernumerary cusp located between the right and noncoronary cusps(Hurwitz type c). He was performed aortic valve replacement with a 21 mm On-X valve.

Aneurysm of Sinus of Valsalva Dissecting into Interventricular Septum: A Possible Cause of Complete Atrioventricular Block

Dissection of the interventricular septum by aneurysm of sinus of Valsalva is a rare lesion and has poor prognosis. However, it can be diagnosed noninvasively with echocardiography and managed well by surgical repair. A 55 year old female was readmitted due to aggravated exertional dyspnea. She was implanted with permanent pace-maker due to complete atrioventricular (AV) block of recent onset at a community hospital. Previous diastolic murmur near aortic area was changed to a new continuous murmur. The diagnosis of an aneurysm of sinus of Valsalva dissected into the interventricular septum was confirmed by routine two-dimensional echocardiography. The neck of the aneurysm was closed primarily with patch and aortic valve replacement was done. The pro-gnosis was good. The finding of AV block of recent onset and obscure origin in a young patient should alert the physician to the possibility of an aneurysm of sinus of Valsalva and warrants systematic echocardiography.

Initial Experience of Rotational Atherectomy in Coronary Artery Disease

BACKGROUND:Rotational atherectomy has been developed for several years. It is a useful tool in complex coronary lesion morphologies such as diffuse, calcific, ostial and angulated lesion. We report initial experience of the rotational atherectomy in complex coronary artery morphology. METHODS: We included 64 patients who was treated with rotational atherectomy since July 1997 to February 1999. Mean age was 56+/-9 years with 47 male patients. Clinical diagnosis was 12 acute myocardial infarction, 49 unstable angina, and 3 stable angina. Rotational atherectomy was done by transfemoral or transradial approach with adjunctive ballooning and/or stenting in all patients. RESULTS: Ninty-one percent of the treated lesions showed complex lesion morphologies (B2/C lesion) with 43 left anterior descending artery and 19 right coronary artery. Rotational atherectomy was done in 37 de novo lesion (58%) and 27 (42%) restenosis patients. Transradial approach was done in 33 patients (52%). Mean maximal burr size was 1.68 mm and mean burr to reference artery ratio was 0.63. Rotastenting were done in 58% of the patients with higher post-procedure minimal lumen diameter, % diameter stenosis and net gain than rotablator with adjunctive balloon angioplasty. Overall procedural success was 94% (62/64). Complications were one non-Q infarction, one coronary artery perforation, two slow flow, and one guidewire fracture. None of the patients showed inhospital mortality or 30 day cardiac event (death, emergency CABG, Q-infarction, or re-intervention). CONCLUSION: Rotational atherectomy is a useful technique with high success rate without showing major cardiac events during inhospital period and within 30 days.

Significance of Serum Troponin-T Level in Acute Ischemic Pain Syndrome / 대한내과학회지

OBJECTIVES: In coronary arterial disease, quantitative assessment of the extent of myocardial damage is important both in management of the patient and prediction of prognosis. Measurement of serum Troponin-T is a new method for detecting myocardial cellular injury, used as more specific marker of tissue damage and reperfusion status in acute myocardial infarction, This study was performed to evaluate the significance of serum Troponin-T measurement in various acute chest pain syndrome. METHODS: 37 patients who presented anterior ischemic chest pain enrolled from April, 1994 to September, 1995, From the initial period of admission, serial measurements of serum level of cardiac enzymes (CK, CK MB, Myoglobin, Troponin-T) were made. Then release time, peak time and normalization time of each enzyme were derived and compared each other. To evaluate whether Troponin-T level can reflect the extent of ischemic injury, correlation between peak Troponin-T level and peak CK MB level was analysed by regression method. RESULTS: 1) Acute myocardial infarction was confirmed in 15 cases; Q-wave myocardial infarction was 10 cases(anterior wall-5 cases, inferior wall-4 cases, lateral wall-1 cases), and non Q-wave myocardial infarction was 5 cases. Unstable angina was 22 cases. All cases had significant stenosis in coronary angiography. 2) The appearance in the serum level of 4 cardiac enzymes was as follows. The release time(hours) of 4 cardiac enzymes(Troponin-T, CK, CK MB, Myoglobin) were 7.1(1-30), 9.3(1-30), 9.9(1-30), 6.2(1-30). The peak time(hours) of 4 cardiac enzymes were 23.0(1.5-96), 21.6(2-66), 16.9(2-42), 12.7(3-40). The normalization time(hours) of the enzymes were over 72, 53.7(11-86), 52.3(11-94), 32.3(10-82). 3) Elevation pattern of cardiac enzymes showed concordance of all 3 enzymes(Troponin-T, CK MB, Myoglobin) in 29 of 43 cases(67.4%), There was concordance of 2 enzymes in 10 cases; 5 cases of CK MB and Myoglobin, 5 cases of Troponin-T and Myoglobin. In 4 cases, only Myoglobin level was increased. 4) There was significant correlation between peak Troponin-T level and peak CK level(r=0.66, p=0.0178), significant correlation was also observed between peak Troponin-T level and peak CK MR level(r=0.90, p=0.0001). CONCLUSION: In acute myocardial infarction serum Troponin-T was detectable as early as CK MB, and lasted longer after other enzyme level was normalized. There was significant correlation between peak Troponin-T level and peak CK, CK MB level, suggesting Troponin-T as useful marker for assessing the extent of myocardial damage.

Atrioventricular plane displacement in the patients with congestive heart failure

No abstract available.