PURPOSE: We evaluated the indications of operation and radiologic findings in 12 operated DeBakey type III aortic dissections. MATERIAL AND METHODS: We retrospectively reviewed radiologic findings of 12 operated DeBakey type III aortic dissections, using CT, MRI, or aortography, and correlations were made with clinical course of the patients. RESULTS: Three cases were uncomplicated dissections. There were aneurysm rupture in 4 cases, impending rupture in 4 cases, occlusion of common lilac artery in 2 cases, occlusion of renal artery in 1 case, and compression of bronchus and esophagus by dilated aorta in 1 case. Associated clinical sign and symptoms were chest and back pain in 12 cases, claudication in 3 cases, dyspnea and dysphagia in 1 case, hoarseness in 1 case, and hemoptysis in 1 case. Post-operative complications were death from aneurysm rupture in 1 case, paraplegia in 2 cases, acute renal failure in 3 cases, and hemopericardium in 1 case. CONCLUSION: Although medical therapy is preferred in management of DeBakey type Ill aortic dissection, surgical treatment should be considered in patients with radiological findings of aortic rupture, impending rupture, occlusion of aortic major branches.
Acute Kidney Injury ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortography ; Arteries ; Back Pain ; Bronchi ; Deglutition Disorders ; Dyspnea ; Esophagus ; Hemoptysis ; Hoarseness ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Pericardial Effusion ; Renal Artery ; Retrospective Studies ; Rupture ; Thorax

Phlebosclerotic colitis is a rare disease of intestinal ischemia and differentiating it from the typical ischemic colitis. It is caused by venous obstruction due to colonic and mesenteric venous calcification. We report a 36-year-old woman presenting with intermittent abdominal pain. Initial radiologic findings showed multiple tortuous thread-like calcifications in the region of the right side of the colon and transverse colon on plain abdominal radiographs and computed tomography images. In the colonoscopy, edematous dark-bluish colonic mucosa, sclerotic colon wall, and multiple ulcers without clear boundaries were observed from the ascending colon to the transverse colon. In the sigmoid colon only showed the edematous dark-bluish colonic mucosa, sclerotic colon wall. On the basis of these findings, we diagnosed the patient as having phlebosclerotic colitis. We report a rare case of phlebosclerotic colitis in healthy young woman.
Abdominal Pain ; Adult ; Colitis* ; Colitis, Ischemic ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Female ; Humans ; Ischemia ; Mucous Membrane ; Rare Diseases ; Ulcer

No abstract available.
Hypertension*

BACKGROUND: The optimal screening tools for hepat ocellular carcinoma are regular tests of alpha fetoprotein (aFP)and liver ultrasonography every 6 months in high risk group. To implement successful long-term project for reducing cancer-mortality,it is essential to know the reasons f or non-compliance among the high risk group. METHODS: A telephone survey was done a mong the hepatitis B surface antigen positive patient group who had not receiveda follow-up test of aFP and liver ultrasonography. This group was selected among the patients who had received health examinations from January,2002 to December,2002 at a university hospital center for health promotion, and the reasons for non-compliance were inquired. RESULTS: There were no stati stical di fferences i n educational level,economic status,age,and sex between the patient group who had taken appropriate follow-up tests and the group who had not. But there were statistically significant differences in the admission history and t ransf usi on hi st ory bet ween t he t wo groups. The reasons for non-compliance were as follows:1. ignorance to the significance of follow-up examination (41.7%),2.lack of time (27.8%),3.no specific signs of cancer (22.2%),4.high costs (5.6%),and 5.fear of discovering serious disease. CONCLUSION: It is important to have patients educated on the significance of screening and early diagnosis of hepatocellular carcinoma.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Compliance ; Early Diagnosis ; Follow-Up Studies ; Health Promotion ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Liver ; Mass Screening* ; Telephone ; Ultrasonography

OBJECTIVE: Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. MATERIALS AND METHODS: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. RESULTS: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=0.84~4.50, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=0.20~ 0.63, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=0.20~0.61, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI= 0.10~0.88, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=0.60~0.99, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. CONCLUSION: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.
Abortion, Spontaneous* ; Alanine ; Alleles ; Case-Control Studies ; DNA ; Female ; Genetic Markers ; Genotype ; Glutamic Acid ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases* ; Pregnancy ; Risk Factors ; Vascular Diseases

Gouty ulcer can be caused by the accumulation of clumps of uric acid in body tissues that lead to acute or chronic inflammation at sites of accumulation. Furthermore, tophi-inhibiting granulation tissue may form a canal that channels microbial infection from the underlying involved joint space, and thus, presents the risk of osteomyelitis development. Accordingly, gouty ulcer must be treated appropriately. In this case, refractory wounds on gouty ulcers at the left shin and left radial ankle were treated by surgical debridement. Negative-pressure wound therapy was used successfully to prevent post-operative delayed wound healing.
Ankle ; Debridement ; Gout ; Granulation Tissue ; Inflammation ; Joints ; Negative-Pressure Wound Therapy* ; Osteomyelitis ; Ulcer* ; Uric Acid ; Wound Healing ; Wounds and Injuries

Cocaine analogue, CFT (2beta-carbomethoxy-3beta-(4-fluorophenyl) tropane) binding to dopamine transporter (DAT) in different species is quite heterogeneous. CFT is scarcely detected in bovine DAT whereas it is conspicuous in humans. To examine the structural basis for this functional discrepancy, we analyzed transporter chimeras of these two DATs. The CFT binding activities are avid in all of the chimeric DATs of which both of the 3rd and the 6-8th transmembrane domain (TM) are composed of human DAT sequences. On the contrary, CFT binding activities were scarcely detected if either or both of two regions are replaced with bovine sequences. These findings indicate that the CFT binding absolutely requires human DAT sequences, at least, in the regions encompassing the 3rd and 6-8th transmembrane domain (TM), and that these regions might contribute to form the 3-dimensional pocket for CFT binding.
Animal ; Cattle ; Chimeric Proteins/genetics/metabolism ; Cocaine/*analogs & derivatives/*metabolism ; Human ; Membrane Transport Proteins/*genetics/*metabolism ; Protein Binding ; Protein Structure, Tertiary

Percutaneous transhepatic biliary drainage (PTBD) is a modality that is used to decompress obstructive jaundice due to impacted stones, benign stricture or cancer. The PTBD catheter is removed percutaneously after the restoration of internal biliary drainage. We experienced a case of a 62-year-old man with peritonitis due to the migration of the PTBD catheter into the peritoneal cavity; we successfully removed it using peroral endoscopy. Although rare, the PTBD catheter may migrate into the peritoneal cavity during the removal of it. In these cases, clinicians should consider the peroral endoscopic removal of the PTBD catheter.
Catheters* ; Cholestasis ; Constriction, Pathologic ; Drainage* ; Endoscopes ; Endoscopy ; Humans ; Jaundice, Obstructive ; Middle Aged ; Peritoneal Cavity ; Peritonitis*

PURPOSE: The aim of this study is to analyze the clinical results of using the technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff. MATERIAL AND METHODS: Form January 2005 to January 2007, we performed the arthroscopic biceps repair with incorporating suture to the rotator cuff for 21 patients with large or massive rotator cuff tear. The mean follow up period was 23 months (range: 6-48months). The number of males and females was 9 and 13, respectively. The age distribution ranged from 47 to 73 years with a mean age of 60.3 years. We compared the preoperative score with the postoperative scores using the University of California Los Angeles (UCLA) score, the shoulder index of the American Shoulder and Elbow Surgeons (ASES) and a simple shoulder test (SST). RESULTS: The improvement in the VAS, ASES and the UCLA and SST scores was statistically significant at the final follow up (average follow-up 23 months) (p>0.05). Two of nine cases were found to have partial tear with continuity but seven cases were found to have complete tear according to the ultrasonography and MRI. CONCLUSION: The technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff is considered to be recommendable.
Age Distribution ; California ; Elbow ; Female ; Follow-Up Studies ; Head ; Humans ; Los Angeles ; Male ; Rotator Cuff ; Shoulder ; Sutures ; Tendons

STUDY DESIGN: Retrospective study. OBJECTIVES: We reported the therapeutic usefulness of a selective nerve root block (SNRB) for patients with a single level spinal stenosis. SUMMARY OF LITERATURE REVIEW: Selective nerve root block for the radiculopathy due to lumbar disc herniation, spinal stenosis, and spondylolisthesis have been reported frequently. MATERIALS AND METHODS: We retrospectively examined 44 patients with single-level spinal stenosis, for whom surgical treatment was considered due to the failure of other conservative treatments from January 2005 to January 2010. All 44 patients were admitted for surgical decompression. Selective nerve root block was done just before a final decision of surgical procedure; patients with his or her 50% or more pain reduction could avoid surgery. RESULTS: In fourty-four cases, twenty-seven pateints underwent a surgical operation. Seventeen patients avoided surgical procedures by successful SNRB. As a result of a 3 year follow-up, the VAS score was significantly and continuously low on the operation group (p=0.02~0.03). K-ODI and Roland-Morris Disability scores were low in both groups until 1 year after the operation and SNRB procedure (p=0.026~0.042, p=0.03), but there was no statistically significant difference beteween the two groups after 2 years upon follow-up (p=0.072~0.14, p=0.06). Generally, the operation group had good results until 1 year after operation and had better tendency for improvement. The data displayed a high probability of surgical treatment among the patients with foraminal stenosis (p=0.039) highlight - this sentence says there is no difference after 1 year and there is still no difference after 2 years. If this is true, the sentence needs to be rewritten so that it says both times show no difference. If there is a difference between 1 year and 2 year then the sentence needs to be rewritten to make this more clear. The next sentence seems to say they are different. CONCLUSIONS: Selective nerve root block avoided the surgical intervention in 39% of the patients with the spinal stenosis refractory to the conservative treatment. Thus it is one of options for the refractory spinal stenosis.
Appointments and Schedules* ; Constriction, Pathologic ; Decompression, Surgical ; Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis* ; Spondylolisthesis