No abstract available.
Pancreatitis, Chronic*

No abstract available.
Tretinoin*

Tibial nonunion is often associated with the soft tissue atrophy and the local circulatory disturbance, so it is important to minimize the soft tissue injury and maintain the stability at fracture site for bone union. We reviewed 29 cases of subcortical onlay bone grafts and plate fixations for the nonunion and delayed union of tibial shafts, from Jan. 1988 through Jan. 1994. The results were as follows. 1. Twenty-nine patients who had nonunion of the tibia underwent subcortical cancellous onlay bone graft and plating, and 28 fractures(96.6%) went on to union. 2. Subcortical elevation or shingling of cortical bone fragments of the tibial cortex, is advocated to provide sound biological condition in atrophic soft tissue envelope. 3. Narrow DCP encouraged early motion and reliably promoted obtaining anatomical alignment. So, in treatment of protracted tibial nonunion, especially in an area with deficient soft tissue or unyielding scar tissue, subcortical onlay bone graft and plate fixation is very useful method, result in good union and no skin problem.
Atrophy ; Cicatrix ; Humans ; Inlays ; Methods ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants

Aneurysms of the superior mesenteric artery are rare, accounting for 8% of visceral artery aneurysms. About 60% of all superior mesenteric artery aneurysms have a mycotic origin. The only helpful clinical manifestations are episodes of previous abdominal pain and a history of valvular heart disease. In this case, a 66-year-old female patient with mitral regurgitation and aortic regurgitation presented with pain in the upper abdominal area. A superior mesenteric artery aneurysm was diagnosed at the time of impending rupture. Since excellent collateral circulation was present, an aneurysmectomy without revascularization was performed, and no ischemic symptom occurred. The patient presented no major complications during the postoperative course.
Abdominal Pain ; Aged ; Aneurysm ; Aneurysm, Infected* ; Aortic Valve Insufficiency ; Arteries ; Collateral Circulation ; Endocarditis* ; Female ; Heart Valve Diseases ; Humans ; Mesenteric Artery, Superior* ; Mitral Valve Insufficiency ; Rupture

Objectives: ：We investigated relationship between sleep time and depression in the aged 65 years or older. Methods: ：This study was based on the data from seventh Korean National Health and Nutrition Examination Survey (KNHANES). 3,285 people aged 65 years or older were selected as the subjects of this research. The demographic characteristics, sleep time and Patient Health Questinnaire-9 (PHQ-9) were administered for each subjects. Depression was defined as above 10 points of PHQ-9. Results: ：All the demographic variables such as age, sex, education, household income, marital status, drinking and smoking except Body Mass Index (BMI) were correlated with the depression. When we corrected the variables, inadequate sleep time groups (less than 6 hours or more than 9 hours) tended to be depressed. Conclusions ：The study results showed the significant correlation between sleep time and depression in the aged 65 years or older. Adequate sleep time is important to prevent the depression of the aged.

PURPOSE: Vascular endothelial growth factor (VEGF) known as an angiogenic factor is a potent inducer of pathologic neovascularization. The purpose of this study is identifying the relationship between serum PSA, invasiveness and VEGF expression in prostatic cancer. MATERIALS AND METHODS: Ex-vivo study with immunohistochemical stain analysis for VEGF expression was performed on 18 paraffin embedded specimens of prostatic cancer patients who were treated with radical prostatectomy. VEGF expressions were classified by three groups (1+ , 2+ , 3+ ) according to the degree of staining of cancer cell. Biochemical failure and recurrence were determined by Takayama's IMx PSA assay criterion (>0.1ng/ml) following radical prostatectomy. RESULTS: Immunohistochemical studies demonstrated that each group contained 1, 2, 8 patients in advanced disease (n=11), and 3, 2, 2 patients in localized disease (n=7), respectively. All cases in strong positive (3+ ) group had Gleason sum higher than 7 and nadir PSA values were lower than 0.1ng/ml except one case. We found no correlation between initial PSA and VEGF expression (p=0.361). Three biochemical recurrent patients were identified as strong positive VEGF expression. CONCLUSIONS: Our study indicates that patients with advanced stage and higher Gleason sum have a trend with more VEGF expression than patients with localized disease. Identifying the angiogenesis factors especially, VEGF involved in prostatic cancer growth and understanding their regulation will lead to the developement of anti-angiogenic strategies useful for diagnostic studies and therapeutic interventions.
Angiogenesis Inducing Agents ; Humans* ; Neovascularization, Pathologic ; Paraffin ; Prostate-Specific Antigen* ; Prostatectomy ; Prostatic Neoplasms* ; Recurrence ; Vascular Endothelial Growth Factor A*

In prostate cancer patients without local invasion and metastasis, radical prostatectomy is performed as a rule for the resection of residual cancer. In a few cases, little amount of cancer volume is identified in radical prostatectomy specimens. This finding has been described as 'minimal residual cancer' or 'vanishing cancer phenomenon' and some reports have demonstrated an increase in the incidence of minimal residual prostate cancer. However, only few cases with 'minimal residual cancer' or 'no residual cancer' despite efforts searching for other possibilites have been reported. We report a case of no residual cancer in radical prostatectomy specimens of biopsy-proven prostate cancer.
Humans ; Incidence ; Neoplasm Metastasis ; Neoplasm, Residual* ; Prostate* ; Prostatectomy* ; Prostatic Neoplasms*

PURPOSE: The purpose of this study is to evaluate the clinical features that necessitate a temporary stoma for the treatment of colonoscopic perforations. RESULTS: Between January 2000 and July 2006, 30 patients were treated for colonoscopic perforation. Based on the perforation sites, we classified these patients into the following groups: proximal colon, sigmoid colon, and rectum; we then reviewed clinical data, including the time to operation and management. RESULTS: Seventeen patients had a perforation during the diagnostic colonoscopy. Of these patients, 14 patients had sigmoid colon perforation. Six underwent an operation within 10 hours after perforation. Of these six, four were managed by primary repair or resection with anastomosis, one sigmoid colon cancer patient by anterior resection, and one rectal cancer patient by low anterior resection with diverting ileostomy. Eight patients underwent more than 12 hours after perforation. Of these eight, three were managed by resection with anastomosis and diverting ileostomy and five by resection with end colostomy. Thirteen patients had a perforation during the therapeutic colonoscopy. Of these patients, 10 patients had a proximal colon perforation. Of these 10, 3 without fever or peritonitis symptom were managed by conservative management, 6 by primary repair or resection with anastomosis, and 1 transverse colon cancer patient by right hemicolectomy. Three patients had sigmoid colon perforation. Of these three, one was managed by primary repair, one by resection with anastomosis, and one sigmoid colon cancer patient by anterior resection. CONCLUSIONS: The mechanism of perforation, the site of the perforation, and the time to operation are associated with intraperitoneal contamination and have an influence on surgical treatment.
Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Colostomy ; Fever ; Humans ; Ileostomy ; Peritonitis ; Rectal Neoplasms ; Rectum ; Sigmoid Neoplasms

PURPOSE: To report a case of a primary conjunctival epithelial cyst in the orbit. CASE SUMMARY: A 60-year-old woman was referred for evaluation of proptosis of the left eye, which had developed about 2 years earlier. Upon initial examination, a movable mass was palpated in the medial aspect of the left orbit. Magnetic resonance imaging of the orbit showed a 2.5 cm-sized, ovoid, cystic mass located between the left eyeball and the medial wall of the orbit. Excisional biopsy of the orbital mass was performed. The orbital mass was a well-circumscribed cystic lesion, adherent to the medial rectus muscle. Histological examination revealed that the cyst was lined with multiple layers of cuboidal epithelium with goblet cells. A diagnosis of primary conjunctival cyst was made. CONCLUSIONS: The possibility of primary conjunctival cyst should be considered in the differential diagnosis for an orbital cystic mass.
Biopsy ; Diagnosis, Differential ; Epithelium ; Exophthalmos ; Eye ; Female ; Goblet Cells ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Orbit

It is essential during extracorporeal membrane oxygenation (ECMO) to extend the activated clotting time (ACT) using anticoagulants to prevent blood clot formation. Traditionally, heparin has been used as an anticoagulant during ECMO. Hemorrhaging due to systemic heparinization is considered a major complication of ECMO. A 48-year-old man was admitted due to cardiogenic shock with acute myocardial infarction. ECMO was instituted because of recurrent ventricular tachycardia and refractory shock. We used nafamostat mesilate (Futhan) as an anticoagulant to reduce hemorrhagic complications. The total bypass time was 153 h. The average dose of nafamostat mesilate was 2.64+/-1.11 mg/kg/h; the average ACT was 128.68+/-21.24 seconds. Only a few units were transfused, and there was no oxygenator failure or hemorrhagic complications. Thus, nafamostat mesilate may reduce the need for transfusions and hemorrhagic complications during ECMO.
Anticoagulants ; Extracorporeal Membrane Oxygenation ; Guanidines ; Hemorrhage ; Heparin ; Humans ; Mesylates ; Middle Aged ; Myocardial Infarction ; Oxygen ; Oxygenators ; Shock ; Shock, Cardiogenic ; Tachycardia, Ventricular