No abstract available.
Glycogen Storage Disease* ; Glycogen*

No abstract available.
Fistula*

Radiation therapy was the treatment of choice for CML in the past, in the form of Sl or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently Sl in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of Sl on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mar's Hospital, Catholic College. Response to Sl has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-elated systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after Sl, and survival after a confirmative diagnosis and Sl.
Bone Marrow ; Diagnosis ; Drug Therapy ; Humans ; Karnofsky Performance Status ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Particle Accelerators ; Phosphorus ; Spleen ; Splenomegaly

PURPOSE: To determine the usefulness of flexible intramedullary fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS: We reviewed 22 cases of forearm diaphyseal fractures treated with flexible intramedullary nail and K-wire. The radiographic assessment was based on the time to union, maintenance of reduction and angular deformity. The functional outcome was assessed with the range of motion and complications at last follow up. RESULTS: Average length of follow up was 13.9 months with mean age of 10.8 years and the time to union was 5.2 weeks. There were no angular deformity and fuctional results were excellent in all cases. There were 5 cases of soft tissue irritation of nail insertion site as post operative complication which was resolved after nail removal. CONCLUSION: Flexible intramedullary for pediatric forearm bone fractures is an effective and safe method which gives a good functional outcome.
Congenital Abnormalities ; Follow-Up Studies ; Forearm* ; Fractures, Bone* ; Methods ; Range of Motion, Articular

BACKGROUND AND OBJECTIVES: here are several reports of cardiac rehabilitation (CR) having beneficial effects on the reduction of cardiovascular mortality and in the prevention of recurrent coronary events in patient with myocardial infarction (MI). An 8-week CR program was investigated to see if it affected the prognostic factors, such as inflammatory markers, after acute MI. SUBJECTS AND METHODS: 33 male and 5 female patients, with a mean age of 55+/-10 yrs, were consecutively assigned to the CR (n=19) and the control (n=19) groups three weeks after acute MI. The 8-week CR program consisted of life style modification and aerobic exercise training. At the baseline, and after 8 weeks, the symptom limited exercise test and peripheral blood sampling were performed to measure the physiologic capacity, the serum levels of high sensitive C-reactive protein (hs-CRP) and the plasma levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha. The interval changes of each parameter were compared between the two groups. RESULTS: The interval increments of the maximal oxygen uptake (14.3% vs. 10.6%, CR vs. control group, p=0.014), anaerobic threshold (18.8% vs. 7.0%, CR vs. control group, p=0.044) and exercise duration (9.4% vs. 3.1%, CR vs. control group, p=0.009) were larger in the CR than in the control group. The magnitudes of the interval changes in hs-CRP, IL-6 and TNF-alpha, as inflammatory markers, did not differ between the two groups (p>0.05). CONCLUSION: This 8-week CR program demonstrated an improved exercise capacity for MI patients, but a larger clinical trial, with modified exercise intensity and duration, will be necessary to detect any possible effect on the inflammatory markers.
Anaerobic Threshold ; C-Reactive Protein ; Exercise ; Exercise Test ; Female ; Humans ; Interleukin-6 ; Interleukins ; Life Style ; Male ; Mortality ; Myocardial Infarction* ; Oxygen ; Plasma ; Rehabilitation* ; Tumor Necrosis Factor-alpha

PURPOSE: Patients with hematologic diseases such as chronic myeloid leukemia (CML) or chronic lymphoid leukemia (CLL) are known to have an increased chance of acquiring a secondary neoplasm. Stomach cancer is one of the most common malignant diseases in Korea, and we investigated whether the incidence of secondary stomach cancer in patients with a hematologic disease increases, in order to determine if a more intensive screening program for detecting secondary gastric cancer was required. We also investigated the safety of performing a gastrectomy in hematologic disease patients. MATERIALS AND METHODS: From 1992 to 2006, the medical records of 8376 patients diagnosed with one of the six common hematologic diseases were reviewed. RESULTS: Nine secondary stomach cancers were found among the 8376 patients during the 15-year observation period. No surgical-related complications occurred, and there was no recurrence of stomach cancer if detected early. CONCLUSION: It seems that a more intensive screening program for detecting secondary gastric cancer in hematologic disease patients is not required, and surgery is not risky in these patients.
Gastrectomy ; Hematologic Diseases* ; Humans ; Incidence ; Korea ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mass Screening ; Medical Records ; Recurrence ; Stomach Neoplasms* ; Stomach*

OBJECTIVE: We wanted to retrospectively evaluate the long-term therapeutic results of iliac arterial stent placement that was done in a single institution for 10 years. MATERIALS AND METHODS: From May 1994 to April 2004, 206 patients who underwent iliac arterial stent placement (mean age; 64+/-8.8) were followed up for evaluating the long term stent patency. Combined or subsequent bypass surgery was performed in 72 patients. The follow up period ranged from one month to 120 months (mean; 31+/-25.2 months). The factors that were analyzed for their effect on the patency of stents were age, the stent type and diameter, the lesion site, lesion shape, lesion length, the Society of Cardiovascular and Interventinal Radiology criteria, the total run off scores, the Fontaine stage and the cardiovascular risk factors (diabetes mellitus, hypertension and smoking). Follow-up included angiography and/or CT angiography, color Doppler sonography and clinical evaluation with the ankle-brachial index. RESULTS: Two hundred and eighty-four stents were placed in 249 limbs of 203 patients. The technical success rate was 98% (203/206). The primary patency rates of the stents at 3, 5, 7 and 10 year were 87%, 83%, 61% and 49%, respectively. One hundred seventy-seven patients maintained the primary stent patency until the final follow up and 26 patients showed stenosis or obstruction during the follow up. Secondary intervention was performed in thirteen patients. Lesions in the external iliac artery (EIA) or lesions in both the common iliac artery (CIA) and EIA were a poor prognostic factor for stent patency. The run off score and stent diameter also showed statistically significant influence on stent patency. The overall complication rate was 6%. CONCLUSION: Iliac arterial stent placement is a safe treatment with favorable long term patency. Lesions in the EIA or lesions in both the EIA and CIA, poor run off vessels and a stent having the same or a larger diameter than 10 mm were the poor prognostic factors for long term stent patency.
Vascular Patency ; Treatment Outcome ; *Stents ; Risk Factors ; Retrospective Studies ; Middle Aged ; Male ; *Iliac Artery ; Humans ; Female ; Arterial Occlusive Diseases/*therapy ; Aged, 80 and over ; Aged

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pulse-spray pharmacomechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodyalitic access, and to identify contributory patency-related factors following interventional procedures. MATERIALS AND METHODS: Between August 1995 and July 2001, 105 cases of insufficient hemodyalitic access involving 38 artificial arteriovenous fistulae (AVF) and 67 graft arteriovenous fistulae (AVG) were treated interventionally. The patients underwent PTA alone in 53 cases and PSPMT combined with PTA in 47, and procedural success and long-term patency were evaluated in terms of a patient's age and sex, the presence of diabetes, the location of access, the type of AVG, the draining vein of AVG, the presence of central vein stenosis, the degree of residual stenosis, and the method of interventional procedure, and contributory factors were thus identified. RESULTS: The overall technical success rate of interventional management was 83.8% (88/105), while the overall primary patency rate was 58.7+/-5.2% at 6 months, 43.0+/-6.0% at 1 year, and 18.1+/-6.0% at 2 years. In AVF/AVG groups, primary patency rates were 55.9+/-9.2%/57.8+/-6.5% at 6 months, 45.8+/-10.0%/42.7+/-8.4% at 1 year, and 21.8%+/-9.8%/18.9+/-6.5% at 2 years. The overall secondary patency rate was 40.0+/-8.1% at 2 years. No contributory factors were found (95% confidence level), though patency of access decreased when residual stenosis was more than 30% (p=0.054). CONCLUSION: Interventional management of insufficient hemodyalitic access has high success and patency rates, and is an effective primary method. There appear to be no contributory factors, though residual stenosis of more than 30% tends to decrease the patency of hemodialytic access.
Angioplasty ; Arteriovenous Fistula ; Constriction, Pathologic ; Humans ; Renal Dialysis* ; Transplants ; Urokinase-Type Plasminogen Activator ; Veins

The common bile duct classically enters the posteromedial aspect of the second part of the duodenum through an oblique, 1 to 2 cm long intramural tunnel. Some case reports of the common bile duct emptying into other sites including the fourth part of the duodenum, the pyloric canal, stomach and duodenal bulb have appeared in the literature. We report a case of a 40-year-old man who showed anomalous drainage of the common bile duct into the duodenal bulb presenting with obstructive jaundice and duodenal ulcer. This patient required choledochoenteric anastomosis to relieve obstructive jaundice and abdominal pain. We report the case with a review of other cases in Korean literature.
Abdominal Pain ; Adult ; Common Bile Duct* ; Drainage* ; Duodenal Ulcer ; Duodenum ; Humans ; Jaundice, Obstructive* ; Stomach

BACKGROUND AND OBJECTIVES: The purpose of this study was to assess the results of a newly developed aortic valve repair technique. SUBJECTS AND METHODS: Between December 1997 and April 2005, 75 aortic valvuloplasties were performed using a new technique that addressed the 3 main components of the aortic root; annulus, sinotubular junction and leaflet. An internal synthetic strip and ring were implanted along the fibrous annulus to reduce the annulus and sinotubular junction, and additional leaflets were implanted for leaflet correction. Based on the primary pathology, there were 35, 22 and 18 cases of isolated aortic regurgitation, aortic regurgitation due to ascending aortic aneurysm and aortic regurgitation due to annuloaortic ectasia, respectively. RESULTS: The average age of the subjects was 46.4+/-16 years; there were 51 and 24 males and females, respectively. There was no operative mortality, with a 2-year freedom from reoperation rate of 97%. Follow up echocardiograms showed significant improvements in the grade of aortic regurgitation, from a preoperative mean of 3.1+/-1.2 to 1.08+/-0.7 immediate postoperatively, to 1.15+/-0.6 at the final follow up. CONCLUSION: The results of the current study showed this technique to be effective in the treatment of aortic regurgitation of various causes. Although long-term results are pending, it is our contention that this aortic valve repair technique will be a reliable method in the future.
Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortic Valve* ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Freedom ; Humans ; Male ; Marfan Syndrome ; Mortality ; Pathology ; Reoperation