ABSTRACT
BACKGROUND AND OBJECTIVES: The elderly is the fast growing segment of the population in Korea. Elderly patients undergoing coronary revascularization are considered a high-risk group. Few data exist that relate the results of stenting in treating coronary artery disease in the elderly population. This study sought to compare the short- and long-term outcomes of elderly patients undergoing coronary artery stenting with those of younger patients. METHODS: All elderly patients 70 years of age who underwent coronary artery stenting between January 1997 and July 1999 (n = 106) at our centers were compared to the patients <70 who underwent coronary artery stenting during the same time period (n = 597). METHODS: Elderly patients presented with lower ejection fraction (52.9% vs. 57.4%, p = 0.001), more unstable angina (47% vs. 31%, p = 0.003), and more multivessel disease (67% vs. 51%, p = 0.005) than younger patients. Major in-hospital complications including death (0.9% vs. 0.5%, p = NS), procedural acute Q-wave myocardial infarction (0.9% vs. 0.3%, p = NS), and emergency CABG (0% vs. 0.3%, p = NS) did not differ between two groups. And also vascular complication rate was similar between two groups(1.9% vs. 1.0%, p = NS). Angiographic follow-up, obtained in both groups, demonstrated similar restenosis rates (26.5% vs. 24.9%, p = NS). Long-term clinical follow-up at 12 months showed major adverse cardiac events including death, acute myocardial infarction, and repeat revascularization were significantly higher in elderly patients than in younger patients (18.3% vs. 12.6%, p = 0.04). CONCLUSIONS: Elderly patients with higher risk factors who underwent coronary artery stenting had similar rates of in-hospital procedural complications and similar rates of 6 months angiographic restenosis, compared to younger patients. Overall rates of major adverse cardiac events in the elderly population at 12 months postcoronary artery stenting were significantly higher than those of younger patients.
Subject(s)
Aged , Humans , Angina, Unstable , Arteries , Coronary Artery Disease , Coronary Vessels , Emergencies , Follow-Up Studies , Korea , Myocardial Infarction , Risk Factors , StentsABSTRACT
OBJECTIVES: We intended to evaluate the relationship between voice and the menopause, so we observed vocal symptoms and voice parameters in patients of postmenopausal syndrome compared with those in premenopausal women. MATERIALS AND METHODS: Forty postmenopausal and twenty premenopausal women were included in this study. Each woman was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The voices were recorded and analyzed by the Multi-Dimensional Voice Program and a Laryngograph. A statistical analysis of voice parameters was done by a paired-t-test. RESULTS: Vocal symptoms detected in the menopausal women were lowered pitch, voice fatigue, recurrent hoarseness, and loss of high tone. Jitter in postmenopausal group was significantly increased compared with the premenopausal group, but the fundamental frequency, shimmer, the Harmonics-to-noise ratio and the closing quotient showed no significant differences. There were no significant changes of voice parameters between menopausal patients with and without vocal symptoms. CONCLUSION: The change of voice may be objectively identified in postmenopausal women. In treating the postmenopausal symptoms, it may be required to take voice changes into consideration.
Subject(s)
Female , Humans , Hoarseness , Menopause , Voice Disorders , VoiceABSTRACT
BACKGROUND AND OBJECTIVES: The p16, cyclin D1, their partners Cdk4/Cdk6, and pRb constitute a G1 regulatory pathway commomly targeted in tumorigenesis. Genetical, immunochemical, and functional analyses show abnormalities of this pathway in various tumors including head and neck squmaous cell carcinoma. To investigate the clinicopathologic meanings of p16 protein and the relationship between p16 and cyclin D1 in head and neck squmous cell carcinoma. MATERIAL AND METHOD: Formalin-fixed paraffin-embeded tumor materials that were obtained from 37 patient with head and neck squmaous cell carcinoma were analyzed by immunohistochemical staining method using antiserum that were directed against p16 and cyclin D1. RESULTS: 1) Deletion of p16 was found in 67.6% (25/37) of the patients with head and neck squamous cell carcinoma. The deletion was not associated with the clinicopathologic parameters (eg. T and N stages, cell differentiation). 2) Deletion of p16 protein and overexpression of cyclin D1 were identified in 76% (28/37) of the patients with head and neck squmaous cell carcinoma. But deletion of p16 was not affected by the overexpression of cyclin D1 in head and neck squmaous cell carcinoma. CONCLUSION: Deletion of p16 and overexpression of cyclin D1 were identified in head and neck squmaous cell carcinoma. These may abrogate the G1 regulatory pathway. These data suggested that combination of these abnormalities may be important in head and neck turmorigenesis.
Subject(s)
Humans , Carcinogenesis , Carcinoma, Squamous Cell , Cyclin D1 , Cyclins , Head , NeckABSTRACT
BACKGROUND AND OBJECTIVES: The tonsillectomy is one of the most common operations in otolaryngology and is performed with a variety of surgical techniques. It seems that there is no superior technique regarding morbidity in tonsillectomy. So we attempted to find out preferable methods of tonsillectomy in clinical practice by comparing operation time, intraoperative blood loss, postoperative pain, and postoperative hemorrhage. MATERIALS AND METHODS: The 45 patients admitted to the National Medical Center for tonsillectomy between May 1997 and February 1998 were entered into this study. All tonsillectomies were performed under general anesthesia by the same surgeon. Patients were divided into three study groups: group I: dissection/snare and laser: group II: dissection/snare and electrocautery: group III: electrocautery and laser. RESULTS: The results were as follows 1) The operation time was shortest in dissection and snare method. 2) Electrocautery was the more painful method, and throat pain is less in laser but there was no statistical significance. 3) Postoperative otalgia and incidence of postoperative hemorrhage were statistically insignificant between the surgical methods. CONCLUSION: From the above results, dissection and snare can reduce operation time and anesthesia time. Electrocautery or laser is useful in small children with bleeding tendency. For patients whom postoperative pain is the prime concern, laser may be preferable.
Subject(s)
Child , Humans , Anesthesia , Anesthesia, General , Earache , Electrocoagulation , Hemorrhage , Incidence , Otolaryngology , Pain, Postoperative , Pharynx , Postoperative Hemorrhage , SNARE Proteins , TonsillectomyABSTRACT
Sternomastoid tumor has long been recognized as a peculiar fibrous growth of the sternocleidomastoid muscle that usually appears during first several weeks of life. Sternomastoid tumor has often been referred to as "congenital torticollis" or "congenital muscular torticollis" because it is often associated with muscular torticollis. Some authors prefer to discuss them separately as either "sternomastoid tumor" when mass is palpable, or "muscular torticollis" when only tightness of sternomastoid muscle is present. Although it is disputed whether sternomastoid tumor will lead to muscular torticollis, 1/4-1/3 numbers of sternomastoid tumor does progress to muscular torticollis. However, muscular torticollis may occur in children without history of a mass in the sternocleidomastoid muscle. We present two cases of sternomastoid tumor that is combined with torticollis, one case was treated by physiotherapy and the other by surgery.