OBJECTIVES: This study was performed to study the outcomes of operations in the patients with atherosclerosis obliterans of lower extremities. METHODS: Forty patients underwent vascular bypass operations from January 2006 to December 2010 and were analyzed retrospectively with clinical records. RESULTS: Forty six bypassing procedures were performed in 40 limbs. The type of operations were femoro-popliteal bypass in 29 limbs, femoro-femoral bypass in 15 patiens and popliteo-posterior tibial bypass in 2 limbs. Forty three procedure were done with polytetrafluoroethylene(PTFE) graft and 3 were done with great saphenous vein. The cumulative patency rates of 5years was 58.9% respectively. In two patients, amputations of the lower extremities were done. Reoperations were performed in 9 patients. CONCLUSIONS: A thoughtful management can prevent the progress of atherosclerosis obliterans(ASO) and may preserve the function of lower limb. In this study, bypass surgery using PTFE and great saphenous vein as conduit revealed acceptable patency rate.
Amputation ; Atherosclerosis ; Extremities ; Humans ; Lower Extremity ; Polytetrafluoroethylene ; Retrospective Studies ; Saphenous Vein ; Transplants

OBJECTIVES: This study was performed to investigate the prevalence of nontuberculous mycobacteria (NTM) species and to determine the clinical significance of NTM isolates. METHODS: From January 2003 to July 2011, NTMs were identified using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or reverse blot hybridization assay (REBA). And pulmonary NTM infection was diagnosed by clinical history, underlying disease, radiological and microbiological findings according to the diagnostic criteria of 2007 American Thoracic Society (ATS). RESULTS: Of the 697 AFB culture-positive specimens, NTM was detected in 149 (21.4%) specimens. Among 154 NTM isolates from 149 specimens, M. avium-intracellulare complex (MAC) (48.1%) was the most frequently isolated organisms followed by M. abscessus (13.6%), M. gordonae (9.1%), M. kansasii (8.4%), M. szulgai (3.9%), M. fortuitum complex (3.3%), M. scrofulaceum (2.0%), M. malmoense (1.3%), M. chelonae (1.3%), M. marinum (1.3%), M. genavense (1.3%), M. lentiflavum (1.3%) and M. mucogenicum (0.6%). Among 147NTM isolates from 142 respiratory specimens, 54 NTM isolates (36.7%) were causative organisms in NTM pulmonary infection. CONCLUSIONS: The isolation rate of NTM was 21.4% in clinical specimen, and in some cases NTM species results in pulmonary NTM infection. Because the treatment of pulmonary NTM infection depends on the infecting species, accurate identification and clinical significance of NTM are required for adequate treatment.
Chimera ; Gordonia Bacterium ; Nontuberculous Mycobacteria ; Prevalence

OBJECTIVE: To evaluate the relationship of high sensitivity C-reactive protein (hs-CRP), fibrinogen and homocysteine to carotid intima-media thickness (IMT) in acute ischemic stroke. METHODS: Subjects were 347 patients with acute cerebral infarction. The carotid arterial wall thickness was measured using high resolution B-mode ultrasound. The serum levels of hs-CRP, fibrinogen and homocysteine were measured by latex-enhanced turbidimetric immunoassay, clot scattering method, and chemiluminescence immunoassay respectively. Univariate regression analysis was performed to evaluate the relationship between these levels and carotid IMT. RESULTS: In patients with acute ischemic stroke, carotid IMT was significantly correlated with increased serum levels of hs-CRP and fibrinogen (P < 0.05, P < 0.01, respectively). However association between serum homocysteine and carotid IMT was not statistically significant. CONCLUSIONS: Increased serum levels of hs-CRP and fibrinogen may be correlated with carotid IMT. Measurement of serum hs-CRP and fibrinogen may be helpful for predicting degrees of atherosclerosis in acute ischemic stroke.
Atherosclerosis ; C-Reactive Protein ; Carotid Intima-Media Thickness ; Cerebral Infarction ; Fibrinogen ; Homocysteine ; Humans ; Immunoassay ; Luminescence ; Stroke

OBJECTIVES: Our retrospective study was designed to examine the efficacy of endovenous laser ablation (ELA) in patients with varicose vein. METHODS: One hundred and twenty-five patients (157 limbs) underwent ELA from June 2008 to June 2011. Age of patients, sex, location of lesions, postoperative complications and recurrence rate were analyzed. Follow up was performed by 1week, 4weeks and 8weeks after operation. RESULTS: The mean age of patients was 51.4 years old and men and women were 73 and 52. The prevalence of minor complications was 14.4% and the recurrence rate was 3.2%. CONCLUSIONS: ELA of the varicose vein is effective and safe methods. ELA is simple to perform, relatively atraumatic and well accepted by patients. In my opinion, ELA can be effectively implemented in surgical practice.
Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Postoperative Complications ; Prevalence ; Recurrence ; Retrospective Studies ; Varicose Veins

OBJECTIVES: Growth hormone is expected to delay the degenerative changes of the intervertebral disc and affect the initial recovery process of cartilage injury, but these effects are still open to disputes. METHODS: This researcher injected growth hormone to the intervertebral disc and subcutaneous tissue of rabbits whose degenerative change were induced artificially, and evaluated the treatment effects of growth hormone through a comparison between the injected and control groups of rabbits. The intervertebral discs between the 3th and 4th vertebrae were extracted 4 weeks after the administration of growth hormone and then histologically graded in a quantitative method. Changes in the height of the intervertebral discs were measured after the induction of degenerative changes. After four weeks of the treatment, then, the height changes were measured. RESULTS: In the subcutaneous-growth hormone injected group, any consistent, sequential, and progressive degeneration of the annular fibrosus was not observed through histopathological studies. The disc height also sequentially did not decrease from that at the time of the injury set in this study. CONCLUSIONS: Considering the histopathological findings of the study, the researcher suggests that subcutaneous injection of growth hormone will be a therapeutic model of disc degeneration. But further biochemical or electromicroscopic studies are necessary to clarify the mechanism of delay degenerative disc changes by growth hormone.
Cartilage ; Growth Hormone ; Injections, Subcutaneous ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Rabbits ; Spine ; Subcutaneous Tissue

Malnutrition is an important condition at the elective surgical patient. Malnutrition results in the dysfunction of immune system by impairing the function of neutrophils and lymphocytes. Following gastrointestinal surgical stress, patients experience some degree of immunosuppression, increasing their risk for acquired infectious morbidity and mortality. Immune and nutrition related with infection and hospital stay in elective gastrointestinal surgical patients. Several specific nutrients such as arginine, glutamine, omega-3 fatty acids, zinc, and vitamin D, influence immunological parameters in patients undergoing surgery in laboratory and clinical studies. In conclusion, immune and nutrition may decrease infectious complication rates. However, the treatment effect varies depending on the patient population and the intervention. Further research needs to define the underlying mechanism by which immune and nutrition may be harmful and to identify which products and which patients are associated with clinical benefit.
Arginine ; Diet ; Fatty Acids, Omega-3 ; Glutamine ; Humans ; Immune System ; Immunosuppression ; Length of Stay ; Lymphocytes ; Malnutrition ; Neutrophils ; Vitamin D ; Zinc

Osteoporosis is common among older adults and results in costly osteoporotic fractures. With the aging of the population, low bone mass states will be an increasing clinical issue for both men and women. Screening for this metabolic bone disorder is warranted in most old adults and clinicians must be diligent in identifying persons at risk. The evaluation should include an assessment of risk factors for falls, a bone density test, and consideration of possible secondary causes of osteoporosis. Several medications are available to improve bone density and decrease fractures. There are a variety of pharmaceutical agents that have been recommended for the treatment of osteopenia and osteoporosis including hormone replacement therapy, selective estrogen receptor modulator therapy, anti-resorptive therapy. In addition patients with osteoporosis who have failed anti-resorptive therapy can have a significant improvement in their bone density with anabolic therapy.
Adult ; Aging ; Bone Density ; Bone Diseases, Metabolic ; Female ; Hormone Replacement Therapy ; Humans ; Male ; Mass Screening ; Osteoporosis ; Osteoporotic Fractures ; Risk Factors ; Selective Estrogen Receptor Modulators

The incidence of malignant adrenal tumors, including primary adrenal lymphoma (PAL) and adrenocortical carcinoma (ACC), is rather low. Early differentiation between ACC and PAL is necessary because the therapeutic strategies for the two differ and the prognosis of each disease is poor. Unfortunately, there is no pathognomonic characteristic of PAL, so radiologists have difficulty in differentiating it from ACC. To our knowledge, there have been only two case reports on ACC that was evaluated and followed up using F-18 FDG PET/CT. The previously reported cases were simple, involving only the bilateral adrenal glands. Here, we report on a 52-year-old man diagnosed with PAL that radiologically mimicked ACC. He had findings of heterogeneous enhancement on CT, several adjacent lymphadenopathies with internal necrosis, and abutting hepatic and bilateral crural invasion. After pathological confirmation, we monitored his prognosis using F-18 FDG PET/CT after three cycles of rituximab-CHOP and again after six cycles of treatment.
Adrenal Glands ; Adrenocortical Carcinoma* ; Follow-Up Studies* ; Humans ; Incidence ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Necrosis ; Positron-Emission Tomography and Computed Tomography* ; Prognosis

A 32-year-old multiparous woman (gravida 2, para 2) with a history of previous cesarean section had acute abdominal pain and collapsed at 21 weeks of gestation. Exploratory laparotomy was performed because of the patient's worsening condition; ultrasound examination results were suggestive of massive hemoperitoneum, and fetus in vertex presentation with bradycardia. Uterine rupture between the left lower segment and borderline of the cervix in the anterior wall with active bleeding was confirmed. An uncomplicated classical cesarean section was performed, but the fetus was stillborn due to preterm birth. Hysterectomy was performed after the cesarean section. The patient was admitted to intensive care units for 3 days and was discharged in 12 days following delivery. Placenta percreta at the anterior lower segment of the uterus was confirmed in the pathology report.
Abdominal Pain ; Adult ; Bradycardia ; Cervix Uteri ; Cesarean Section ; Female ; Fetus ; Hemoperitoneum ; Hemorrhage ; Humans ; Hysterectomy ; Intensive Care Units ; Laparotomy ; Pathology ; Placenta Accreta* ; Placenta* ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Premature Birth ; Ultrasonography ; Uterine Rupture* ; Uterus

Although benign nerve sheath tumors have been described, primary tracheal schwannomas are extremely rare. We report a case of primary tracheal schwannoma, a rare benign nerve sheath tumor in a 58-year-old man with atypical symptoms of chronic cough, sputum and dyspnea for 2 months. Chest computerized tomography showed a 1.7 cm polypoid lesion in posterior wall of mid trachea. The results of bronchoscopic biopsy and immuno-histo-chemical studies were consistent with schwannoma. A surgical treatment of tumor resection and tracheal reconstruction by end-to-end anastomosis was performed.
Biopsy ; Cough ; Dyspnea ; Humans ; Middle Aged ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Sputum ; Thorax ; Trachea