Objective: Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. Methods: Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward “right-to-left” continuous suture. The reverse continuous suture (RCS) group used a downward “left-to-right” continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. Results: Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201˚±90.6˚, 102˚±107.6˚, and 0˚ in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9˚±83.7˚ and 180˚±77.9˚, respectively, which yielded a significant difference between these groups (p<0.001). Conclusions We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

BACKGROUND: Gross anatomy and sectional anatomy of a monkey should be known by students and researchers of veterinary medicine and medical research. However, materials to learn the anatomy of a monkey are scarce. Thus, the objective of this study was to produce a Visible Monkey data set containing cross sectional images, computed tomographs (CTs), and magnetic resonance images (MRIs) of a monkey whole body. METHODS: Before and after sacrifice, a female rhesus monkey was used for 3 Tesla MRI and CT scanning. The monkey was frozen and sectioned at 0.05 mm intervals for the head region and at 0.5 mm intervals for the rest of the body using a cryomacrotome. Each sectioned surface was photographed using a digital camera to obtain horizontal sectioned images. Segmentation of sectioned images was performed to elaborate three-dimensional (3D) models of the skin and brain. RESULTS: A total of 1,612 horizontal sectioned images of the head and 1,355 images of the remaining region were obtained. The small pixel size (0.024 mm × 0.024 mm) and real color (48 bits color) of these images enabled observations of minute structures. CONCLUSION: Due to small intervals of these images, continuous structures could be traced completely. Moreover, 3D models of the skin and brain could be used for virtual dissections. Sectioned images of this study will enhance the understanding of monkey anatomy and foster further studies. These images will be provided to any requesting researcher free of charge.
Anatomy, Cross-Sectional ; Brain ; Dataset ; Female ; Haplorhini ; Head ; Humans ; Macaca mulatta ; Magnetic Resonance Imaging ; Primates ; Skin ; Tomography, X-Ray Computed ; Veterinary Medicine

PURPOSE: This study was designed to provide the basic data for the development of the management program for overactive bladder by ascertaining its prevalence among Korean women aged over 30 years, and the factors related to its occurrence. MATERIALS AND METHODS: The study was performed by using self-questionnaires through the community-based cross sectional study from May to July, 2000. The subjects consisted of 2869 women, aged over 30 up to 89 years, among those who understood and responded to the questionnaires, and was residing in Seoul, Kyongki Kangwon, Chungchong, YongNam, HoNam, Cheju proinces. They also did not have known neurological problem and diabetes mellitus. The data were analyzed by Student t-test, chi2-test, and multiple logistic regression with using SAS program. RESULTS: The results were as follows ; 1. They all experienced at least one of frequency, urgency, nocturia, urge incontinence for the past one year and 52.3% of the subjects had experienced symptom at least once in 5 voidings. The highest prevalence of overactive bladder was 86.2% in the category for 70 to 89 years, 74.3% for the sixties, 45.3% for the forties, 42.5% for the thirties. In the symptoms of 1499 women among subject, 19.4% of them had nocturia, 18.2% frequency, 10.5% urgency, 9.6% urge incontinence, 9.5% frequency and urgency, 5.9% frequency and nocturia. 2. The age(OR = 1.041, 95% Cl = 1.027, 1.055) and the menopause(OR = 0.696, 95% Cl = 0.527, 0.919) were related to overactive bladder occurrence. CONCLUSIONS: The above findings indicated that about the half of the women aged over 30 years had symptoms for overactive bladder, and the prevalence was higher in old women and the women with menopause. So, the prevention and management programs for overactive bladder are required to be developed, and the primary screening programs based on community shall be developed.
Diabetes Mellitus ; Female ; Gangwon-do ; Gyeonggi-do ; Humans ; Jeju-do ; Logistic Models ; Mass Screening ; Menopause ; Nocturia ; Prevalence ; Surveys and Questionnaires ; Seoul ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge

OBJECTIVE: Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age.METHODS: We reviewed 23 consecutive patients ≤20 years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes.RESULTS: The patients’ ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period.CONCLUSION: In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.
Adolescent ; Aneurysm ; Aneurysm, False ; Child ; Female ; Follow-Up Studies ; Headache ; Humans ; Incidence ; Intracranial Aneurysm ; Male ; Medical Records ; Pediatrics ; Risk Factors ; Seizures ; Treatment Outcome

OBJECTIVE: The aim of this study was to demonstrate changes of subjective medication satisfaction and clinical benefit after once-daily paliperidone extended release (ER) in treatment of schizophrenia. METHODS: In an open-label, observational, and multicenter study, 374 patients with schizophrenia who switched to paliperidone ER due to any reason were recruited. Medication Satisfaction Questionnaire (MSQ), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement and visual analogue scale for sleep (VAS) were assessed at baseline, 4 weeks and 8 weeks after treatment. We also examined the type, frequency, and severity of adverse events newly formed. RESULTS: Among 374 patients, 320 patients (76.5%) were included in the intent-to-treat analysis set. The mean dose of paliperidone ER was 5.33+/-2.31 mg/day at the initiation. At the endpoint, the mean dose of paliperidone ER was 6.68+/-3.13 mg/day. The percentages of patients satisfied with medication were changed from 40.9% at baseline to 67.8% at endpoint (p<0.001). Both CGI-S scores and VAS for daytime drowsiness were significantly decreased after 8 weeks (both p<0.0001) and mean scores of MSQ and VAS for sleep quality were improved after 8 weeks (both p<0.0001). CONCLUSION: After switching to paliperidone ER, 67.8% of patients with schizophrenia who had any reason to switch medication showed subjective satisfaction for medication and clinical improvement without significant adverse events. Regarding that medication satisfaction was associated with changes of clinical states, medication satisfaction can be used for measures for clinical scales in the treatment of schizophrenia.
Humans ; Isoxazoles ; Prospective Studies ; Pyrimidines ; Surveys and Questionnaires ; Schizophrenia ; Sleep Stages ; Weights and Measures