Attenuation of Dickkopf 1-Induced Hair Growth Inhibition in Cultured Human Hair Follicles by Tianeptine

No abstract available.

Attenuation of Dickkopf 1-Induced Hair Growth Inhibition in Cultured Human Hair Follicles by Tianeptine

No abstract available.

Ectopic ovarian mixed epithelial tumor simulating colon cancer in a woman with a unicornuate uterus / 대한내과학회지

Ovarian malignancy can rarely present as a colonic mass and simulate colon cancer. Mullerian anomalies are congenital anatomic abnormalities of the female internal genitalia, of which a unicornuate uterus is a rare subtype. Several cases of gynecologic malignancies arising in Mullerian anomalies have been described. However, an ectopic ovarian malignancy in conjunction with a unicornuate uterus has never been reported. We report a case of ectopic ovarian mixed epithelial tumor, a very rare subtype of ovarian epithelial tumor, which presented as a colonic mass simulating colon cancer in a woman with a unicornuate uterus.

Ectopic ovarian mixed epithelial tumor simulating colon cancer in a woman with a unicornuate uterus / 대한내과학회지

Ovarian malignancy can rarely present as a colonic mass and simulate colon cancer. Mullerian anomalies are congenital anatomic abnormalities of the female internal genitalia, of which a unicornuate uterus is a rare subtype. Several cases of gynecologic malignancies arising in Mullerian anomalies have been described. However, an ectopic ovarian malignancy in conjunction with a unicornuate uterus has never been reported. We report a case of ectopic ovarian mixed epithelial tumor, a very rare subtype of ovarian epithelial tumor, which presented as a colonic mass simulating colon cancer in a woman with a unicornuate uterus.

Efficacy of Combination Chemotherapy with Paclitaxel and Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To evaluate the efficacy and toxicity of the combination therapy of paclitaxel and cisplatin in advanced, non-small cell, lung cancer patients MATERIALS AND METHODS: Between December 1997 and September 2001, 37 patients with advanced, non-small cell, lung cancer were enrolled in this study. Patients were treated with paclitaxel (135 mg/m2, 24 hr infusion) and cisplatin (75 mg/m2). The treatments were repeated every 4 weeks. RESULTS: Among the 37 patients enrolled, 21 were treated with paclitaxel and cisplatin as a first-line and 16 patients as a second-line. The median age of the patients was 59. In the first-line group, 10 had stage IIIB and 11 had stage IV, non small cell lung cancer. Of 21 patients in first-line treatment group that could be evaluated, objective responses were observed in 6 patients (response rate: 28.6%, CR: 4.8%, PR: 23.8%). The mediansurvival duration for patients was 48 weeks. With the second-line group, 3 patients showed a partial response (response rate: 18.7%) to treatment, with median survival duration of 44 weeks. Grade 3-4 leukopenia was observed in 27.1% of the first-line, and 23.6% in second- line, treatment groups. CONCLUSION: Combination chemotherapy, with paclitaxel and cisplatin, in non-small cell lung cancer has acceptable toxicities in both first and second-line treatment groups. In terms of efficacy, no superior response was shown for either group. More randomized studies, with a larger group of patients, are required to prove the true efficacy.

Treatment with alpha-glucosidase inhibitor for severe reactive hypoglycemia: A case report / 대한내과학회지

Gastrectomy or vagotomy may result in reactive hypoglycemia, which, in some cases, can reduce the plasma glucose levels to 30~40 mg/dL due to rapid digestion and absorption of food, especially carbohydrate. We treated the patient with frequent episode of severe hypoglycemia. Reactive hypoglycemia is caused by an excessive insulin secretion after a sharp rise in plasma glucose. He had undergone total gastrectomy due to stomach cancer 4 years before. Since nutritional treatment did not successfully manage his reactive hypoglycemia, an alpha-glucosidase inhibitor, voglibose was administered. His hypoglycemic symptoms disappeared and a rapid change of plasma glucose and insulin levels were attenuated after the alpha-glucosidase inhibitor treatment. The effects of alpha-glucosidase inhibitor were documented in a 5-hour oral glucose tolerance test, where not only insulin and C-peptide rise was clearly attenuated, but also the blood glucose concentration did not fall low enough to induce hypoglycemic symptoms. This therapy was very effective and the patient has not had any recurrence of reactive hypoglycemia since the initiation of the therapy.

Usefulness of cyfra 21-1 as a tumor marker of lung cancer / 대한내과학회지

BACKGROUND: Cytokeratins are epithelial markers whose expressions are not lost during malignant transformation. The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 110 patients with lung cancer. The aims of this study were to confirm sensitivity of Cyfra 21-1 in detecting non-small cell cancer, to assess the potential relationship between Cyfra 21-1 and disease stage of the lung cancer. METHODS: We measured serum levels of four tumor marker (NSE, CEA, SCC Ag, Cyfra 21-1) in 110 patients with lung cancer. The measurement of serum level of Cyfra 21-1 was performed with a cut off value of 3.3 ng/mL. An immunoradiometric assay was used to detect a fragment of the cytokeratin 19. The patients were grouped according to the stage of the disease and tumor type. RESULTS: Overall sensitivity of Cyfra 21-1 was relatively high (51.8%) than others tumor markers. Sensitivity of this marker was especially high for adenocarcinoma (63.2%) and squamous cell carcinoma (54.1%). In contrast, sensitiviy of Cyfra 21-1 was relatively low for small cell lung carcinoma (40.0%). Serum levels of Cyfra 21-1 were higher in advanced nonsmall cell lung cancer than early stage disease. CONCLUSION: We conclude that Cyfra 21-1 is a sensitive tumor marker of nonsmall cell lung cancer, especially adenocarcinoma and also may be a useful adjunctive marker for disease monitoring.

Clinical efficacy of various tumor markers in medical screening / 대한내과학회지

BACKGROUND: Many tumor markers have been investigated for early diagnosis of the malignancy, yet they were turned out to be inappropriate for the purpose. This study was carried out to investigate the efficacy of tumor markers. METHODS: Employing radioimmunoassay, CEA, AFP, CA19-9, PSA, CA125 were done in 31,389 patients(20,878 males, 10,511 females) who visited our medical screening center from Jan. 1 1997 to Dec. 31 1997. RESULTS: Total mean value of CEA is 1.90+/-1.37 ng/mL(male: 2.17+/-1.37, female: 1.37+/-0.86). Male showed significantly higher level of CEA. Only 2 subjects had values over 25 ng/mL, and one was diagnosed to have stomach cancer but the other did not. Total mean value of AFP is 2.46+/-6.47 ng/mL (male: 2.32+/-3.55 ng/mL, female: 2.73+/-10.06 ng/mL). Female showed significantly higher level of measured AFP. One had AFP value over 400 ng/mL and was diagnosed of hepatoma. Total mean value of CA19-9 is 11.48+/-7.61 ng/mL,(male: 10.9+/-26.78 ng/mL, female: 12.61+/-8.97 ng/mL). Female showed significantly higher CA19-9. 65 subjects (male: 31, female: 34) showed measured CA19-9 level over 37 ng/mL. 5 subjects had values over 100 ng/mL and 1 subject was diagnosed of pancrease cancer. Total mean value of PSA is 0.79+/-1.88 ng/mL. 90 subjects showed measured PSA level over 4 ng/mL and mean value in this group was 10.92 ng/mL. 54 subjects were older than age 50. 4 out of 90 subjects were diagnosed of prostate cancer. Total mean value of CA125 is 13.08+/-10.93 ng/mL. 160 subjects showed measured CA125 level over 35 ng/mL. 19 subjects had value over 100 ng/mL and none of the malignancy was detected. CONCLUSION: Tumor markers are inappropriate measures for screening of malignancy.

Etoposide and cisplatin combination chemotherapy in extensive stage small cell lung cancer / 대한내과학회지

BACKGROUND: Small cell lung cancer (SCLC) disseminates early and has poor prognosis. However, SCLC is highly chemosensitive, thus chemotherapy has been established as the primary mode of treatment. This study evaluated the efficacy and toxicity of etoposide in combination with cisplatin in the treatment of extensive stage small cell lung cancer. METHODS: Thirty four patients (28 males, 6 females) with previously untreated extensive stage small cell lung cancer were treated with etoposide at a dose of 100 mg/m2, IV on days 1-3 with cisplatin at 100 mg/m2, IV on day 1. The median age was 63 (range 41~80). This combination chemotherapy was administered every 3-4 weeks. Response rate, response duration, survival, and toxicity were evaluated. RESULTS: The response rate was 50%. The median survival time was 29 weeks. The median response duration was 17.2 weeks in responders. The toxicity was acceptable. CONCLUSION: This study illustrated that the combination of etoposide and cisplatin is effective in the treatment of extensive stage small cell lung cancer, and can be administered with acceptable toxicity. Although this study was not designed to be a formal comparative trial, the efficacy and toxicity observed with this regimen were found to be comparable to previous reports.

Adenocarcinoma of unknown primary site / 대한내과학회지

BACKGROUND: To study clinical characteristics and treatment outcomes of adenocarcinoma of unknown primary site (ACUPS). METHODS: A retrospective analysis of 81 patients who were diagnosed as ACUPS, seen at Samsung Medical Center from May, 1995 to July, 1999, was performed. RESULTS: The median age of the patients was 58 years. The common sites of metastases were the lymph node, liver, lung, bone. In 49 of 81 patients (60.5%), the dominant tumor location was below the diaphragm. The majority of patiens (76 of 81) were initially treated with systemic chemotherapy including cisplatin. Responses were evaluable in 70 of 76. Eighteen of 70 patients (25.7%) responded to chemotherapy and complete remission was observed in 6 patients. The overall median survival of 81 patients was 5.6 months. The median survival of the responding patients was 18.3 months but the median survial of the nonresponding patients was 4.6 months (p<0.01). In univariate and multivariate analysis, age, performance status and response to initial chemotherapy were significant prognostic factors for overall survial. CONCLUSION: Poor survival rate and treatment response were observed in ACUPS but complete response and long-term survival were observed in several patients.

Clinical investigation of gastric MALT lymphoma / 대한내과학회지

BACKGROUND: Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach has recently been defined as a distinct clinicopathologic entity, often associated with Helicobacter pylori (H. pylori) infection. Characteristics and treatment outcomes of 57 patients with gastric MALT lymphoma were analyzed. METHODS: Retrospective analysis of 57 cases of gastric MALT lymphoma who underwent treatment with various modalities at Samsung Medical Center from Mar. 1995 to Jul. 2000 was performed. RESULTS: The median age of the patients was 47 years (ranged from 22 to 75 years) and the ratio of males to females was 1.1:1. The presenting symptoms were abdominal pain, indigestion and GI bleeding. By Modified Ann Arbor system, stage IE accounted for 70.2%, stage II1E 14.0%, stage II2E 14.0%, and stage IV 1.8%, respectively. H. pylori had been evaluated histologically in 49 cases of which 81.6% was positive. Low grade histology accounted for 71.9% and high grade histology 28.1%. Treatment modalities included H. pylori eradication, surgery, chemotherapy, radiotherapy and their combination therapy. In one case, the patient was observed without treatment. Complete remission rate was 98.2%. H. pylori eradication alone resulted in lymphoma regression successfully in 20 out of 23 patients. With median follow-up of 33 months (3-61 months), median survival was not reached. Overall 3 year survival rate was 94.7%. CONCLUSION: Regardless of treatment modality, high survival rate (3 year survival rate 94.7%) was obtained. H. pylori eradication was feasible and safe in the cases of low grade, stage I, and H. pylori-positive lymphoma, and allowed stomach preservation. Longer follow-up evaluation is required to determine the long-term efficacy and side effects of H. pylori eradication.

Correlation between VEGF Expression and Prognostic Factors in Breast Cancer / 대한암학회지

PURPOSE: Archival tissues of breast cancer patients were examined for VEGF expression to evaluate the relationship with other clinicopathologic factors and prognostic significance of VEGF in breast cancer. MATERIALS AND METHODS: Paraffin sections from 76 patients with invasive breast cancer who have been treated at Samsung Medical Center from December, 1994 to April, 1998 were examined for VEGF expression by immunohistochemical staining using anti-VEGF antibody. We analyzed relationships between VEGF expression and tumor size, tumor stage, metastasis, steroid honnone receptors, p53, disease recurrence and survival. RESULTS: Immunostaining showed variable VEGF positivity in the malignant cells and VEGF was detected more frequently in tumors than in adjacent non-tumorous breast tissues. 74 out of 76 (97.4%) was positive for VEGF. We found that the expression of VEGF was strongly correlated with the stages of breast tumor (P=0.020), lymph node metastasis (P=0.043) and PR (P=0.016). However, we could not find statistically significant relationship between VEGF expression and tumor size, ER, p53 and distant metastasis. CONCLUSION: VEGF may be a useful prognostic indicator in patients with breast cancer, especially correlated with tumor stage and lymph node metastasis. This result warrants further study to confirm our findings.

Protracted Venous Infusion of 5-Fluorouracil as a Chemotherapy in Colorectal Cancer / 대한암학회지

PURPOSE: The administration of 5-fluorouracil (5-FU) by protracted intravenous infusion is an alternative to the bolus administration of 5-FU in patients with advanced colorectal cancers. This study was performed to evaluate the response rate and toxicities of protracted infusion of 5-FU in patients with advanced or recurrent colorectal cancers who had been treated with 5-FU by bolus or shortterm continuous administration. MATERIALS AND METHODS: Between March 1995 and June 1997, twenty-eight patients with advanced colorectal cancer previously exposed to 5-FU based chemotherapy were enrolled in this triaL Patients received 5-FU (250 mg/m(2)/day days 1-28) or 5-FU plus leucovorin (5-FU; 200 mg/m/day days 1-28, leucovorin; 20 mg/m IV days 1, 8, 15, 21) by ambulatory infusion pump. Treatment course was repeated every 42 days until disease progression. RESULT: Twenty-eight patients entered. All 28 patients were assessable for response and toxicity. Five (19%) patients achieved a partial response, with the median response duration of 15 weeks (range; 7-22 weeks), and median survival time of entire patients was 54 weeks (range 7-151+ weeks). Gastrointestinal toxicity, specifically stomatitis was a major toxicity (grade 2, 12%; grade 3, 4%), but hand-foot syndrome was less frequent (5%) compared with other trials with protracted infusion of 5-FU reported in the literature. Hematologic toxicity was generally of low grade. CONCLUSION: Prolonged intravenous infusion of 5-FU can produce a response rate of 19% with low toxicity among patients refractory to bolus or short-term infusion of S-FU.

Optimal Scan Time of Dual-phase Spiral CT in Normal Rabbit Liver: Effect of Contrast Injection Rate

PURPOSE: To determine the effect of contrast injection rate on rabbit liver enhancement and the optimaltem-poral window for dual-phase spiral CT of rabbit liver at each injection rate. MATERIALS AND METHODS: Usingspiral CT, seven New Zealand White rabbits underwent dynamic scanning at one level of liver. Three protocols ofcontrast injection rates were employed, namely 0.3 ml/sec(group 1), 1ml/sec(group 2) and 2 ml/sec(group 3). During120 seconds of total scan time, the scan interval was 3 seconds. Densities of the aorta, liver and portal veinwere averaged in equivalent time. The different injection rate protocols were compared for peak enhancement/timeon a time density curve. RESULTS: Mean peak enhancement (HU) in equivalent time(secs) was 310/18(group 1),383/9(group 2) and 357/6(group 3) in the aorta ; 34/36, 40/36 and 41/30 in the liver ; and 135/36, 153/24 and170/21 in the portal vein. The temporal window during the arterial phase was 12-21 sec(group 1), 6-12 sec(group2), and 6-12 sec(group 3). The temporal window during the portal phase was from 30 sec(0.3ml/sec), 21sec(1ml/sec)and 21 sec(2 ml/sec). CONCLUSION: During dual-phase spiral CT, the temporal window for liver scanningshould be determined according to each contrast injection rate. A slow contrast injection rate prolongs thetemporal window during the arterial phase.

A new member of alpha 1-adrenoceptor-coupled G alpha h (transglutaminase II) family in pig heart: purification and characterization

We previously reported an identification of a 77-kDa GTP-binding protein that co-purified with the alpha 1-adrenoceptor following ternary complex formation. In the present paper, we report on the purification and characterization of this GTP-binding protein (termed G alpha h5) isolated from pig heart membranes. After solubilization of pig heart membranes with NaCl, G alpha h5 was purified by sequential chromatographies using DEAE-Cellulose, Q-Sepharose, and GTP-agarose columns. The protein displayed high-affinity GTP gamma S binding which is Mg(2+)-dependent and saturable. The relative order of affinity of nucleotide binding by G alpha h5 was GTP > GDP > ITP >> ATP > or = adenyl-5'-yl imidodiphosphate, which was similar to that observed for other heterotrimeric G-proteins involved in receptor signaling. Moreover, the G alpha h5 demonstrated transglutaminase (TGase) activity that was blocked either by EGTA or GTP gamma S. In support of these observations, the G alpha h5 was recognized by a specific antibody to G alpha h7 or TGase II, indicating a homology with G alpha h (TGase II) family. These results demonstrate that 77-kDa G alpha h5 from pig heart is an alpha 1-adrenoceptor-coupled G alpha h (TGase II) family which has species-specificity in molecular mass.

Effect of Cytosine Arabinoside and Daunorubicin (AD) Combination Chemotherapy in Acute Myelogenous Leukemia / 대한암학회지

PURPOSE: Important advances in the treatment of acute myelogenous leukemia have been made with the introduction of cytosine arabinoside (ara-C) and anthracyclines (daunorubicin) over the past 20 years. Currently, 60 to 80% of patients with acute myelogenous leukemia achieve complete remission with induction chemotherapy consisting of ara-C and daunorubicin (adriamycin) AD ("7+3"). The one-fourth of complete responders will have extended long-term survival and may be cured. Therefore wetreated patients with acute myelogenous leukemia admitted to our hospital with AD ("7+3") regimen. METHODS: Induction therapy; Thirty four patients with previously untreated acute myelogenous leukemia received AD ("7+3") regimen (ara-C, 200 mg/m2/d by continuous infusion for seven days, and daunorubicin, 45 mg/m2/d for 3 days). The second course of therapy was AD ("5+2"), if the patients failed to enter remission. Consolidation therapy; three cycles of consolidation chemotherapy were administered with at least 4 week interval following remission. Course 1; ara-C at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, 6-thioguanine at every 12 hour 100 mg/m2 orally every 12 hour for 7 days). Course 2; ara-C (same as course 1) at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, vincristine at 1.5 mg/m2 (maximum 2 mg) by bolus injection for 1 day, prednisolone at 40 mg/m2 (maximum 60 mg) orally for 7 days. Course 3; ara-C (same as course 1) daunorubicin at 45 mg/m2 by 1 hour infusion for 3 dyas. RESULTS: Sixty-eight percent of the 34 patients entered complete remission. The remission duration for all patients in complete remission ranged from 4 weeks to 3122+ weeks, with the median of 50 weeks. The median duration of survival in complete responder group was 62 weeks. Twenty-Six percent of patients with complete remission are alive at 5 years. Cases with extramedullary leukemic involvement were found in four patients; M2 with orbital mass, M3 and M4 with CNS leukemia, M5a with subcutaneous nodules. Among the potential prognostic variables including age, initial WBC count, percent of blast in peripheral blood,none was statistically related to prognosis. CONCLUSION: Combination chemotherapy with cytosine arabinoside and daunorubicin is a effective regimen for acute myelogenous leukemia as much as other regimen. Futher clinical trials for effective treatment regimen and method are necessary to raise the complete remission rate.

5-Fluorouracil, Leucovorin, Ifosfamide and Cisplatin (FLIP) Combination Chemotherapy for Adevanced Non-Small Cell Lung Cancer / 대한암학회지

PURPOSE: To evaluate the response rate and toxicity of combination chemotherapy including 5-fluorouracil (F), leucovorin (L), ifosfamide (I) and cisplatin (P) for the previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer. MATERIALS AND METHOD: The doses of FLIP were 5-fluorouracil 800 mg/m2 CI days 1-5, leucovorin 20 mg/m2 IV days 1-5, ifosfamide 1000 mg/m2 CI days 1-3, cisplatin 100 mg/m2 IV day 1 respectively. Cycles were repeated every 3 weeks until disease progression. Seventy-three previously untreated patients were enrolled. Age ranged from 30 to 73 (median 56 years); 43 were male, 30 female. Fifty-three patients had performance status (ECOG) 0-1 and 19 performance status 2. Twenty-two patients had stage IIIB and 51 stage IV. Follow-up ranged from 7+ to 160weeks (median 57 weeks). RESULTS: The overall response rate was 46.7% for 62 evaluable patients. (CR 1 patient, PR 28 patients) Median response duration was 24 weeks (range 1+ to 36+ weeks). Toxicity > Grade II (WHO) included: granulocytopenia 19.8%, anemia 13.5%, nausea and vomiting 31.5% stomatitis 46.5%, neuropathy 24.6%. CONCLUSION: FLIP chemotherapy was comparable to other combination chemotherapy for advanced non-small cell lung cancer with moderate toxicities.

Four Cases of Typhlitis, Developed in Neutropenic State and Treated with Medical Conservative Management / 대한암학회지

Typhlitis is a life threatening necrotizing enterocolitis of the cecum, ascending colon and terminal ileum seen in severely neutropenic patients, however its pathogenesis is not identified up to this time.The incidence of typhlitis in leukemic patient is 10~12%, estimated by postmortem examination, and 46% in induction chemotherapy of leukemia. Recently, entity incidence is more high due to increasing challenges to high dose chemotherapy in solid tumors.We experienced four cases of typhlitis, one was developed in the circumstance of neutropenia induced by induction chemotherapy for acute myelocytic leukemia and others in neutropnia due to primary diseases without chemotherapy, ig, chronic myelocytic leukemia, acute lymphocytic leukemia, myelodysplastic syndrome.All cases were treated with high dose broad spectrum antibiotics in early phase of disease and its outcome was good, so that, early diagnosis of typhlitis is essential, then prompt treatment with high dose antibiotics and intravenous fluid before onset of transmural necrosis is associated with lower morbidity and mortality than surgical resection.

A Case of Cyclosporine Induced Reversible Cortical Blindness / 대한혈액학회지

The immunosuppressive agent, cyclosporine (CSA), has improved the success rate of organ transplantation due to its effectiveness in treating graft versus host diseases. However, as its use has increased, so has the variety of toxicities associated with it, including in the kidney, liver, and central nervous system. The spectrum of neurotoxcity ranges from mild tremor and blurred vision to seizures, ataxia, mental status changes, peripheral neuropathy, and paraparesis. Cortical blindness, an extremely rare form of CSA neurotoxicity, has previously been described in only 15 patients after a bone marrow transplant (BMT). We have experienced a rare case of CSA induced cortical blindness in a 15 year-old girl receiving a bone marrow transplantation for aplastic anemia. Tests showed a high cyclosporine level, a low serum magnesium level, and a low cholesterol. In a brain MRI, we found a diffuse high signal intensity in the parieto-occipital lobe on T2-weighted images. In an awake EEG, there were diffuse slowing waves. A visual evoked potential, performed at the time of initial evaluation, when patient was cortical blind, showed no wave formation in the left occipital recording. After discontinuation of CSA, there was significant improvement of cortical blindness, much improvement in the brain MRI, the brain EEG, and the visual evoked potential.

Recanalization of Chronic Total Occlusion of Coronary Arteries by Prolonged Intracoronary Urokinase Infusion

BACKGROUND: PTCA is often unsuccessful in a patient with chronic total occlusion of coronary arteries with success rates varying from 60 to 70%. Success rates are related to the duration of total occlusion, longer occlusions being associated with lower success rates. Chronic total occlusion may be associated with thrombi superimposed on the stenotic lesion. We used an intra-coronary bolus of urokinase followed by a prolonged urokinase infusion in an attempt to lyse the lesion and allow for passage of the PTCA wire during subsequent angioplasty. The purpose of prolonged durokinase infusion was to reduce the clot sufficiently to recanalize the coronary artery and make it more amenable to PTCA. METHODS: Study patients: We were included six patients who developed total occlusion for more than 3 weeks and good collateral channels of Grade 2 or more and previous attempts at angioplaty had failed. Procedures: All patients underwent dual catheter system and incremental dose protocol of intracoronary urokinase infusion. RESULTS: The mean duration of occlusion was calculated to be 65.3+/-2.7 weeks and urokinase dose ranged from 130,000 to 200,000U/hr and treatment lasted 21.7+/-1.4 hours in our study. The prolonged urokinase infusion resulted in reperfusion of the occluded dvessel in 5 of the 6 patients(83%), with or without the complementary balloon inflation. One patient failed to recanalize the occluded vessel because cardiac tamponade was developed during the prolonged urokinase infusion. CONCLUSION: We concluded that the prolonged urokinase infusion in occluded coronary artery appeared to increase the likelihood of successful PTCA in patients with chronic total occlusion of coronary arteries.Also, in carefully selected patients, prolonged urokinase infusion in occluded coronary artery was relatively safe and well tolerated.