No abstract available.
Carcinoma, Squamous Cell* ; Vagina*

No abstract available.
Aged* ; Humans

No abstract available in English.
Clinical Study ; Spondylolisthesis

STUDY DESIGN: Retrospective study. OBJECTIVES: To conduct an analysis of the union rate and union patterns of local autogenous bone grafts using metal cages, allogenic bone, and local autogenous bone around the cages in posterior lumbar interbody fusion (PLIF). SUMMARY OF LITERATURE REVIEW: Local autologous bone grafting using metal cages is regarded as an effective method for union during PLIF without iliac bone harvesting. There are few studies about the additional bone grafting except using metal cages. MATERIALS AND METHODS: Thirty-nine patients (68 segments) with postoperative computed tomography (CT) results from 6 to 18 months after PLIF were included. We used 2 metal cages filled with local autogenous bone intraoperatively (region C). We also grafted allogenic bone between 2 cages (region A) and local autogenous bone at the side of the cages (region B). Retrospective analyses of the coronal CT sections were performed using the modified Bridwell criteria for assessing the presence of union. A quantitative evaluation was performed using a scoring system that assessed the proportion of radiopaque parts of the union mass. RESULTS: Among the 68 segments, union was observed in 64 segments, resulting in a union rate of 95.6%. The union rates in regions A, B, and C were 86.8%, 89.7%, and 94.1%, respectively. Trabeculation and the quantitative evaluation of union bone showed a statistically significant trend for improvement from regions A to C (p<0.001). CONCLUSIONS: In this study, the complementary effect of additional bone grafting other than local bone grafting was not proven, but it was effective in increasing the fusion area at around 90%. Keeping the height of disc space with the cages, additional bone grafting using local autogenous and allogenous bone may be used as an effective method for stable union.
Bone Transplantation ; Evaluation Studies as Topic ; Humans ; Methods ; Retrospective Studies* ; Transplants*

No abstract available.
Hysterectomy*

Endoscopic biliary drainage has been established as the palliative treatment of choice for malignant obstructive jaundice. But the clogging of biliary endoprosthesis has been a persistent problem faced by endoscopists over many years. Different materials, sizes, and designs have been used in efforts to overcome this problem. Recently, there are some reports that incorporating sideholes increases the risk of stent clogging, and prostheses without sideholes had significantly lower clogging compared to those with sideholes. And then Soehendra and his colleagues introduced a new design Teflon straight stent without sideholes, designated "Tan-nenbaum" (TB) stents, and reported that TB stent had significantly longer patency than Teflon pigtail stent with sideholes. When placing the TB stent, we used OASIS (One Action Stent Introduction System). This introducer enables the stent to be pre-loaded onto the distal tip of the guiding catheter and placed endoscopically in one step. By using OASIS, we reduced the duration of placing the stent in narrowed bile duct and the patients were more tolerable. Now, we report our experience of endoscopic retrograde biliary drainage by use of TB stent and OASIS" in 12 patients with obstructive jaundice due to malignancy.
Bile Ducts ; Catheters ; Drainage ; Humans ; Jaundice, Obstructive ; Palliative Care ; Polytetrafluoroethylene ; Prostheses and Implants ; Stents*

Amyloidosis is classified according to the distribution pattern of amyloid deposition sites and associated diseases. Hepatic amyloidosis is not infrequent, although rarely causes clinical liver disease. We report two cases of amyloidosis diagnosed by liver biopsy. One presented with symptoms related almost to the liver disease, such as jaundice, hepatomegaly and indigestion. Echocardiogram revealed hypertrophic cardiomyopathy, suggesting cardiac involvement of the amyloidosis. The patient died of hepatic failure. The other case was found in a patient with an end stage renal disease. Features of congestive heart failure in this case may reflect cardiac involvement. The pattern of hepatic amyloid deposition in both of these cases was diffuse perisinusoidal. The predominant intralobular deposition suggests that these are amyloidosis of the secondary type.
Amyloidosis/*diagnosis/pathology ; Humans ; Liver Diseases/*diagnosis/pathology ; Male ; Middle Aged

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy

Gallstone pancreatitis is caused by migration of gallstones through the common bile duct and ampulla of Vater, where ohetruction or impaction may occur. Early detection and endoscopic treatment of impacted gallstones are very important for the amelieration of pancreatitis. Pancreatic imagings, such as conventional ultrasonography, computerised tomography(CT) and endoscopic retrograde cholangiypancreatography(ERCP) have beea used for the diagnosis of gallstone pancreatitis. But these imaging net are often unsatisfactory fordetection of the impacted gallstones in the common bile duct ampulla of Vater. Especially ERCP has been contraindicated in acute pancreatitis. Endoscopic ultrasonography(EUS), which was recently developed, has been known as highly accurate diagnostic tool in the diagnosis of biliary and pancreatic disease. The high resolution of EUS is capable of showing unique morphological detail in gallstone pancreatitis. We report 3 cases of gallstone pancreatitis which Was accurately diagnosed by EUS and successfully treated by endoscopic treatment.
Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Endosonography* ; Gallstones* ; Pancreatic Diseases ; Pancreatitis* ; Ultrasonography