PURPOSE: Percutaneous peripheral balloon angioplasty and stent insertion are used for the treatment of peripheral arterial obstructions and stenosis. In this study, we assessed the efficacy of peripheral balloon angioplasty and stent insertion in patients with peripheral arterial disease. METHOD: We performed a retrospective review of patients who underwent peripheral balloon angioplasty or stent insertion in obstructive or stenotic peripheral arterial lesions between July 2003 and November 2006. Follow-up study was performed using lower extremity multi-directional computed tomography (MDCT) or lower extremity angiography. Mean follow-up was 22.8 months. RESULT: A total of 30 patients (47 lesions) were treated. The mean age was 66.8 years, and the ratio of male to female patients was 29 to 1. Calf claudication was the most common chief complaint, and 19 patients had hypertension. Obstructive lesions were found in the common iliac artery (CIA) (18), external iliac artery (EIA) (11), superficial femoral artery (SFA) (15), and anterior tibial artery (ATA) (3). Peripheral balloon angioplasty was performed for 8 lesions, and stent insertion was performed for 39 lesions. Re-stenosis occurred in 9 lesions (3 in the CIA, 5 in the SFA, 1 in the ATA) during follow-up. CONCLUSION: Peripheral balloon angioplasty and stent insertion are useful modalities for the treatment of obstruction or stenosis in lower extremity peripheral arteries. Close follow-up is necessary to improve long-term outcomes.
Angiography ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypertension ; Iliac Artery ; Lower Extremity ; Male ; Peripheral Arterial Disease ; Retrospective Studies ; Stents ; Tibial Arteries

A 59-year-old female patient with rheumatoid arthritis showed hypokalemic metabolic alkalosis, normotensive hyperreninemic hyperaldosteronism and high urinary prostaglandin level. She was thought to have Bartter's syndrome. But, her kidney biopsy specimen showed chronic interstitial nephritis. She have used acetaminophen containing analgesics for recent three years. So we thought her disease was caused by drug. But, in this case, clinical manifestations are correspond with Bartter's syndrome and we have witnessed a successful respond to kalium replacement, angiotensin converting enzyme inhibitor, prostaglandin inhibitor and spironolactone administration.
Acetaminophen ; Alkalosis ; Analgesics ; Arthritis, Rheumatoid* ; Bartter Syndrome ; Biopsy ; Female ; Glycogen Storage Disease Type VI ; Humans ; Hyperaldosteronism ; Kidney ; Middle Aged ; Nephritis, Interstitial* ; Peptidyl-Dipeptidase A ; Prostaglandin Antagonists ; Spironolactone

OBJECTIVE: The etiology and pathogenesis of moyamoya disease remain unclear. Furthermore, the definitive diagnostic protein-biomarkers for moyamoya disease are still unknown. The present study analyzed serum proteomes from normal controls and moyamoya patients to identify novel serological biomarkers for diagnosing moyamoya disease. METHODS: We compared the two-dimensional electrophoresis patterns of sera from moyamoya disease patients and normal controls and identified the differentially-expressed spots by matrix-assisted laser desorption/ionization-time-of flight mass spectrometry and electrospray ionization quadruple time-of-flight mass spectrometry. RESULTS: We found and analyzed 22 differently-expressed proteomes. Two proteins were up-regulated. Twenty proteins were down-regulated. Complement C1 inhibitor protein and apolipoprotein C-III showed predominantly changed expressions (complement C1 inhibitor protein averaged a 7.23-fold expression in moyamoya patients as compared to controls, while apolipoprotein C-III averaged a 0.066-fold expression). CONCLUSION: Although our study had a small sample size, our proteomic data provide serologic clue proteins for understanding moyamoya disease.
Apolipoprotein C-III ; Biomarkers ; Complement C1 Inhibitor Protein ; Electrophoresis ; Humans ; Mass Spectrometry ; Moyamoya Disease ; Proteins ; Proteome ; Sample Size

BACKGROUND: Hemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB) is mainly attributed to impaired filling and diastolic dysfunction. An elevated ratio of the mitral velocity to the early-diastolic velocity of the mitral annulus (E/e' > 15) is a relatively new indicator of diastolic function, and this was reported to be associated with impaired hemodynamics during OPCAB. We investigated the efficacy of milrinone on the perioperative hemodynamics and short term outcomes of patients with an E/e' > 15 and who underwent OPCAB. METHODS: The patients were randomly allocated into either group C (control, n = 31) or group M (n = 31) and they were treated with the same amount of either normal saline or milrinone (0.5 microg/kg/min) without bolus loading after completion of internal mammary artery harvest until the end of operation. Hemodynamic measurements were recorded after the induction of anesthesia (T1), 5 min after starting each distal anastomosis of the left anterior descending artery (T2), left circumflex artery (T3) and right coronary artery (T4), and 5 min after sternum closure (T5). RESULTS: The mixed venous oxygen saturation (SvO2) was lower through T2-T4 compared to the baseline value in both groups, while the degree of the decrease was significantly less in group M than that in group C. The other hemodynamic variables, the operative data and the postoperative outcomes were similar between the two groups. CONCLUSIONS: Intraoperative infusion of milrinone did not significantly improve the perioperative hemodynamics and the subsequent short term outcomes for the patients with preexisting diastolic dysfunction as represented by an elevated E/e' value, although it reduced the degree of decrease of the SvO2 during OPCAB.
Anesthesia ; Arteries ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Hemodynamics ; Humans ; Mammary Arteries ; Milrinone ; Oxygen ; Sternum

No abstract available.
Adult ; Behcet Syndrome/*complications/therapy ; Colitis/*etiology/therapy ; Female ; *Hematopoietic Stem Cell Transplantation ; Humans ; Myelodysplastic Syndromes/*complications/therapy ; Transplantation, Homologous

This study investigated that the antioxidative effect of freeze-dried cranberry powder against protein and lipid oxidation and ameliorative effect of serum lipid profile in rat fed atherogenic diet. Six weeks old male Sprague-Dawley rats were divided into the following four groups: normal diet group with 5% corn oil (control), atherogenic diet group with 5% corn oil, 10% lard, 1% cholesterol, and 0.5% sodium cholate (HFC), atherogenic plus 2% cranberry powder diet group (HFC + C2), and atherogenic plus 5% cranberry powder diet group (HFC + C5), and respective diet and water were fed daily for 6 weeks. After the experimental period, the serum lipid profile, such as total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride, ferric reducing ability of plasma (FRAP), plasma phenolics content, superoxide dismutase (SOD) activity, serum protein carbonyl and thiobarbituric acid reactive substances (TBARS) levels were examined. Total phenolic compound and total flavonoid levels in freeze-dried cranberry powder were 9.94 mg/g and 8.12 mg/g, respectively. Serum total cholesterol and LDL-cholesterol levels were not significantly different for cranberry powder treatment, but serum HDL-cholesterol level was significantly increased in HFC + C5 group compared with HFC group. Plasma FRAP value tended to be increased by cranberry powder treatment though there was no significant difference. Plasma total phenol concentrations and SOD activities were not significantly different among all groups. Serum protein carbonyl and TBARS levels were significantly decreased in HFC + C5 group compared with HFC group. Overall results suggested that freeze-dried cranberry powder might have the serum lipid improving effect, as well as antioxidative effect demonstrated by its protective effect against protein and lipid oxidation.
Animals ; Biomarkers ; Cholesterol ; Corn Oil ; Diet ; Diet, Atherogenic ; Dietary Fats ; Humans ; Male ; Oxidative Stress ; Phenol ; Plasma ; Rats ; Rats, Sprague-Dawley ; Sodium Cholate ; Superoxide Dismutase ; Thiobarbiturates ; Thiobarbituric Acid Reactive Substances ; Vaccinium macrocarpon ; Water

PURPOSE: Endoscopic thyroid surgery has been widely used because of the cosmetic advantage and the development of laparoscopic instruments. We have performed endoscopic thyroidectomy by breast approach and gasless transaxillary approach on papillary thyroid microcarcinomas. In this study, we describe these two types of endoscopic procedures with the technique of the method and surgical outcomes. METHODS: From Oct. 1999 to Oct. 2009, each procedure was performed in 162 patients divided into two groups. Breast approach group was in 91 patients and gasless transaxillary approach group was in 71 patients. We compared the results of mean ages, sex ratio, extent of operation, mean hospital stay, operating time, pathologic characteristics and postoperative complications between the breast approach group and gasless transaxillary approach group. RESULTS: Ninety-one cases treated using breast approach, and seventy-one cases treated using gasless transaxillary approach. The operation time was 197.4+/-60.7 minutes (95~350) in breast approach group, and 100.1+/-19.8 minutes (65~140) in gasless transaxillary approach group. Post operative complications are; 2 cases of transient hoarseness, 8 cases of hypocalcemia (including 2 cases of permanent hypocalcemia), 2 cases of chest wall discomfort in breast approach group, and 1 case of transient hoarseness, 2 cases of transient hypocalcemia, 1 case of postoperative bleeding in gasless axillary approach group. CONCLUSION: Endoscopic thyroidectomy is a safe and technically feasible alternative to conventional thyroidectomy in patients with benign and highly selected malignant disease. We expect it can increase the extent of surgery.
Breast ; Carcinoma, Papillary ; Cosmetics ; Hemorrhage ; Hoarseness ; Humans ; Hypocalcemia ; Imidazoles ; Length of Stay ; Nitro Compounds ; Postoperative Complications ; Sex Ratio ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: Opioid-based patient controlled analgesia (PCA) provides adequate pain control following spinal surgeries at the expense of increased risk of postoperative nausea and vomiting (PONV). We evaluated the efficacy of dexamethasone added to ramosetron, which is a newly developed five-hydroxytryptamine receptor 3 antagonist with a higher receptor affinity and longer action duration compared to its congeners, on preventing PONV in highly susceptible patients receiving opioid-based IV PCA after spinal surgery. METHODS: One hundred nonsmoking female patients undergoing spinal surgery were randomly allocated to either a ramosetron group (group R) or a ramosetron plus dexamethasone group (group RD)., Normal saline (1 ml) or 5 mg of dexamethasone was injected before anesthetic induction, while at the end of the surgery, ramosetron (0.3 mg) was administered to all patients and fentanyl-based IV PCA was continued for 48 hrs. The incidence and severity of PONV, pain score and the amount of rescue antiemetics were assessed for 48 hours after surgery. RESULTS: The number of patients with moderate to severe nausea (20 vs. 10, P = 0.029), and overall incidence of vomiting (13 vs. 5, P = 0.037) were significantly lower in the group RD than in the group R, respectively. Rescue antiemetic was used less in the RD group without significance. CONCLUSIONS: Combination of ramosetron and dexamethasone significantly reduced the incidence of moderate to severe nausea and vomiting compared to ramosetron alone in highly susceptible patients receiving opioid-based IV PCA after surgery.
Analgesia ; Analgesia, Patient-Controlled ; Antiemetics ; Benzimidazoles ; Dexamethasone ; Female ; Humans ; Incidence ; Nausea ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Spine ; Vomiting

PURPOSE: Single port laparoscopic surgery is an area of active investigation in abdominal surgery. A standard procedure for single port laparoscopic adrenal surgery has not been established. We retrospectively investigated intraoperative and postoperative outcomes following laparoscopic adrenalectomy via mono-port (LAMP). METHODS: Between March 2009 and December 2009, 10 patients underwent LAMP at Kangbuk Samsung Hospital. The same surgeon performed all surgeries. The first 5 cases underwent LAMP using an Alexis Wound Retractor (Applied Medical, Rancho Santa Margarita, CA, USA) with surgical gloves, and others were done with an OCTO Port (Dalim Surgnet, Korea). RESULTS: Of the 10 patients, 5 were male and 5 were female. The mean age was 43.7±9.9 years (range, 34~62), and the mean BMI was 24.1±4.0 kg/m² (Range, 17.1 ~30.0). The mean tumor size was 32.5±16.9 mm (range, 12~60),mean operative time was 127.0±29.5 min (range, 90~180), and mean hospital stay was 4.5 days (range, 3~7). Three patients were diagnosed with non-functioning cortical adenoma, 3 with Cushing's syndrome, 2 patients with pheochromocytoma, and others with primarily hyperaldosteronism and myelolipoma. Major postoperative morbidity, blood transfusions, or conversion to open surgery did not occur. CONCLUSION: The outcome of LAMP demonstrates the safety and feasibility of this procedure. With increasing surgeon experience and refinement in instrument technology, we believe LAMP is likely to become a standard approach to adrenal disease.
Adenoma ; Adrenalectomy* ; Blood Transfusion ; Conversion to Open Surgery ; Cushing Syndrome ; Female ; Gloves, Surgical ; Humans ; Hyperaldosteronism ; Laparoscopy ; Length of Stay ; Male ; Myelolipoma ; Operative Time ; Pheochromocytoma ; Retrospective Studies ; Wounds and Injuries

The objective of the present study was to establish the method of measurement of hydrogen peroxide and to estimate the anti-oxidative effect of genistein in the skin. UVB induced skin oxidation and anti-oxidative effect of genistein formulations were evaluated by determining levels of hydrogen peroxide. The mechanism involved in the determination of hydrogen peroxide is based on a color reaction between ferric ion (Fe3+) and xylenol orange, often called FOX assay and subsequent monitoring of absorbance values of the reactant at 540 nm. The reaction was to some extent pH-dependent and detection sensitivity was greatest at pH 1.75. Genistein liposomal gel demonstrated better anti-oxidative effect with regard to lowering hydrogen peroxide levels elevated by UVB irradiation compared to genistein-suspended gel. A linear relationship has been observed between anti-oxidative effect of genistein and drug deposition in the skin tissue. Genistein liposomal gel resulting in the localization of the drug in the deeper skin led to improved anti-oxidative effect compared to genistein gel. The suggested method for evaluation of oxidation of the skin can be used as a tool to screen effective anti-oxidative agents and their delivery systems acting on the skin.
Citrus sinensis ; Genistein ; Hydrogen Peroxide ; Hydrogen-Ion Concentration ; Phenols ; Skin ; Sulfoxides