BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

No abstract available.
Abruptio Placentae* ; Female ; Pregnancy

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*

The influence of age and menopausal status at diagnosis on the prognosis of patients with primary breast cancer remains controversial. Some studies have found that younger patients have worse clinical outcomes than older patients, others have reported that younger patients have a more favorable outcome, and others have found no relation with age. We analyzed the effects of menopausal status in the survival of patients with operable breast cancer and estimated the correlations between the menopausal status and other established prognostic factors. We reviewed the records of the patients who had been operated on at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University during the past 10 years (1985~1996). The results were as follows: 1) The peak age group was the fifth decade (27%), and all of patients, except one, were females. 2) The most common symptom was a palpable breast mass with or without pain (88%). 3) Most patients (72.8%) visited within 6 months of the first appearance of a symptom, and the most frequent tumor size was 2~5 cm in diameter (58.9%). 4) Most of the primary tumors were located in the upper outer quadrant (61%); tumors located in the lower outer quadrant were rare (3%). 5) The most common TNM stage group was stage II (54.1%), and there was no difference of distribution between the premenopause and the postmenopause groups. 6) The common pathologic cancer types were infiltrating ductal cancer (73.8%), medullary cancer (9.3%), mucinous cancer (8.3%). 7) Axillary lymph-node metastasis was present in 58 cases (62.4%). 8) The overall five-year survival rate for all patients was 43.9%. 9) The five-year survival rates of the 38 premenopausal patients and the 38 postmenopausal patients were 42.4% and 35.8%, respectively, but there was no statically significant difference between the two groups. 10) Menopausal status did not significantly correlated with tumor size, tumor location, lymph-node metastasis or TNM stage. In conclusion, the menopausal status may be not correlated with the prognosis in breast cancer However, the effect of menopausal status on the prognosis of patients with breast cancer needs to be investigated for a large papulation of breast cancer patients.
Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Heart ; Humans ; Mucins ; Neoplasm Metastasis ; Postmenopause ; Premenopause ; Prognosis ; Survival Rate

No abstract available.
Cesarean Section* ; Endometritis* ; Female ; Pregnancy

There have been limited reports about the prevalence and its characteristics of glaucoma in Korea. To clarify further, we retrospectively analyzed the data of 1482 patients with glaucoma from January 1993 to December 1994. The prevalence of glaucoma was 0.58%. The type of glaucoma consisted of secondary glaucoma 33.9%, primary open angle glaucoma(POAG) in 33.2%, angle closure glaucoma(ACG) 28.0%, normal tension glaucoma 4.0% and congenital glaucoma 0.9%. The mean age of the patients with POAG was 55.2+/-16.5 and that of ACG was 64.7+/-9.2. In POAG, the age group over 40 years old occupied 79.7% while 99.3% was the age group over 40 years in ACG. The incidence rate of men was higher than women in POAG but in women it was 3.6 times higher than men in ACG. Secondary glaucomas due to diseases of uveal tract, neovascular glaucoma, steroid induced glaucoma, and aphakic (or pseudophakic) glaucoma were 37.0%, 18.9%, 16.5%, and 15.7% respectively.
Adult ; Female ; Glaucoma* ; Glaucoma, Angle-Closure ; Glaucoma, Neovascular ; Humans ; Incidence ; Korea ; Low Tension Glaucoma ; Male ; Prevalence ; Retrospective Studies

Since the first report by Tansini in 1896, the latissimus dorsi muscle free flap has been widely used for various types of soft tissue defect due to reliable anatomy with a sufficient diameter of neurovascular pedicle and a sizable muscle. However, for relatively small soft tissue defect, latissimus dorsi free flap offers several distinct disadvantages of donor site including loss of the posterior axillary fold and flattening of the posterolateral chest wall, weakness of upper arm strength in extension, adduction and internal rotation. We treated three patients having various types of soft tissue defect using segmental latissimus dorsi muscular free flap depending on its descending branch of thoracodorsal neurovascular pedicles. There were no serious complications during 18 months of mean follow-up. We concluded that this method has some advantages such as no weakness of strength of the upper arm including walking on crutches, preserving the posterior axillary fold, preventing winging of the scapula and increased chance of using a flow-through technique. Here we present our cases of reconstruction of soft tissue defect using segmental latissimus dorsi free flap with a review of the literature.
Arm ; Crutches ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Scapula ; Superficial Back Muscles* ; Thoracic Wall ; Tissue Donors ; Walking

Background: This study investigated whether concomitant facial bone (FB) fractures reduce temporal bone (TB) injuries, such as posttraumatic facial palsy and vertigo, through an impact absorbing effect, so-called “cushion effect,” in severe trauma patients. Methods: A total of 134 patients with a TB fracture were included. They were divided into two groups according to their concomitant facial fractures: group I (no FB fracture) and group II (FB fracture). We compared clinical characteristics, such as brain injury, trauma severity, and complications of TB fracture, between the two groups. Results: In group II, immediate facial palsy was more frequent (11.6% vs. 1.5% in group I), and the Injury Severity Score was higher (19.0 ± 5.9 vs. 16.7 ± 7.3, P = 0.020). Delayed facial palsy (12.3% in group I vs. 4.3% in group II) and posttraumatic vertigo (24.6% vs.7.2%) occurred more often in group I. FB fractures significantly decreased the incidence of posttraumatic vertigo (odds ratio [OR], 0.276; 95% confidence interval [CI], 0.083–0.914). Intraventricular hemorrhage (OR, 20.958; 95% CI, 2.075–211.677), facial nerve canal injury (OR, 12.229; 95% CI, 2.465–60.670), and FB fractures (OR, 16.420; 95% CI, 1.298–207.738) increased the risk of immediate facial palsy. Conclusion Concomitant FB fractures reduced the risk of the occurrence of delayed facial palsy and posttraumatic vertigo in injured patients with TB fracture. Particularly, an anterior force may be reduced by the cushion effect of the bony fracture.

No abstract available.
Esophageal Achalasia