We found an error in this article. The author's affiliation.

BACKGROUND: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. METHODS: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. RESULTS: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). CONCLUSIONS: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins ; Medical Records ; Motor Activity ; Pneumothorax ; Retrospective Studies ; Subclavian Vein ; Vascular Access Devices ; Vena Cava, Superior ; Venous Thrombosis

Finite element analyses were performed to study effects on stress distribution generated in jaw bone for various shapes of dental implants: plateau type, plateau with small radius of curvature, triangular thread screw type in accordance with ISO regulations and square thread screw filleted with small radius partially. It was found that square thread screw filleted with small radius was more effective on stress distribution than other dental implants used in analyses. Additional analyses were performed on the implant with square thread screw filleted with small radius for verying design parameters, such as the width of thread end, the height of the thread of the implant and load direction, to determine the optimum dimensions of the implant. The highest stress concentration occurred at the region in jaw bone adjacent to the first thread of the implant. The maximum effective stress induced by a 15 degree oblique load of 100 N was twice as high as the maximum effective stress caused by an equal amount of vertical load. Stress distribution was more effective in the case when the width of thread end and the height of thread were p/2 and 0.46p, respectively, where p is the pitch of thread. At last, using tensile force calculated from the possible insert torque without breading bone thread, finite element analysis was performed on the implant to calculate pre-stress when the primary fixation of the implant was operated in jaw bone. The maximum effective stress was 136.8 MPa which proven to be safe.
Bread ; Dental Implants ; Finite Element Analysis ; Jaw ; Radius ; Social Control, Formal ; Torque

Pulmonary sequestration is an unusual malformation consisting of isolated nonfunctioning lung segments lacking communication with functional tracheobronchial trees. Systemic blood supply is commonly from the thoracic aorta, but arteries occasionally arise from other sites. We report a rare form of pulmonary sequestration with arterial supply from the right coronary artery.
Aged ; Bronchopulmonary Sequestration/*pathology/radiography ; Coronary Angiography ; Coronary Vessel Anomalies/*pathology/radiography ; Female ; Humans

OBJECTIVE: Left ventricular hypertrophy is common and major complication in patients with end stage renal disease (ESRD), but pathogenesis is not clear. We have used echocardiography to evaluate influential factors and contractile performance according to the geometry of left ventricle. METHODS: We measured left ventricular mass, the extent of pericardial effusion and systolic function of left ventricle with M-mode and two dimensional echocardiography in 99 cases of ESRD from March 1993 to March 1996. RESULTS: 1) Body surface area and systolic blood pressure was higher in men than those in women. But, there was no difference in LV mass index or systolic function between the sex. 2) Among the 99 patients with ESRD, 89 cases (90%) had increased ventricular mass and 10 cases had normal ventricular mass. In the left ventricular hypertrophy groups, 60 cases had concentric hypertrophy, 29 cases had eccentric hypertrophy. 3) In patients with normal ventricular mass, hypertension and pericardial effusion were less frequent than in those with left ventricular hypertrophy. In patients with concentric hypertrophy, systolic blood pressure and body surface area were increased and serum albumin was decreased as compared to patients with eccentric hypertrophy. In patients with eccentric hypertrophy, duration of dialysis was increased. But, the result of Logistic analysis showed that systolic blood pressure and serum albumin were reliable factors for the geometry of left ventricle. 4) In patients with eccentric hypertrophy, LV mass index was significantly correlated with the concentration of serum alkaline phosphatase and phosphate. But, in patients with concentric hypertrophy, any factors were not correlated with LV mass index. 5) Systolic performances such as ejection fraction and fractional shortening were decreased in patients with eccentric hypertrophy. 6) The pattern of left ventricular hypertrophy was not different among non-dialysis group, hemodialysis group and CAPD group. CONCLUSION: In patients with ESRD, left ventricular hypertrophy is a common complication and most common hypertrophic type is concentric hypertrophy. The geometry of left ventricular hypertrophy may be influenced by various factors such as systolic blood pressure and serum albumin concentration and influence on the systolic performance of left ventricle. Further study for the geometry of left ventricle and the prognosis may be necessary for the improvement of cardiovascular complications in patients with ESRD.
Alkaline Phosphatase ; Blood Pressure ; Body Surface Area ; Dialysis ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic* ; Male ; Pericardial Effusion ; Peritoneal Dialysis, Continuous Ambulatory ; Prognosis ; Renal Dialysis ; Serum Albumin

INTRODUCTION: Cathepsin D (CD) is a lysosomal protease that can be used as an important prognostic cytosolic factor for breast cancer. Its over-expression in breast cancer cells and in the host stromal cells in the tumor has been proposed as being a poor prognostic indicator. However, its prognostic value is still being debated. Therefore, CD expression needs to be examined in more relevant subsets of tissue in order to refine its prognostic significance and the clinical applications. METHODS: Regardless of the lymph node status, 110 T1 invasive ductal carcinomas of the breast were immunohistochemically evaluated for the CD expression using rabbit anti-cathepsin D monoclonal antibody. This study separately assessed the expression of CD in the invasive component (IDC), in the in situ component (DCIS), and in the juxtatumoral stromal cells (JTSC). The CD expression level in these three kinds of tissues were correlated with the nuclear grade, ER, PR, c-erb-B2, p53, the N stage, the T stage, and the 5 year metastasis-free survival. RESULTS: Positive CD expression in the JTSC was associated with the T stage (p = 0.001) and the N stage (p = 0.029), whereas positive CD expression in the DCIS and IDC was not. In addition, strong CD expression in the JTSC correlated with the nuclear grade of the invasive component (p = 0.024). In all three components, no statistically significant correlation was found between the biomarker (ER, PR, cerb-B2, p53) and the CD expression. On univariate analysis, positive expression in the JTSC was correlated with a poor 5 year- metastasis free survival (p = 0.007), but the positive expression in the IDC and DCIS was not. CONCLUSION: CD expression of the JTSC could represent the N stage, the T stage, and the nuclear grade of T1 IDC. Whether or not it would have an independent influence on the prognosis of T1 IDC, CD expression in the JTSC is probably an indicator of the tumor virulence. CD expression in the JTSC will provide an important clue for the development of new CD targeted therapies, and it will serve as an important criterion for selecting the appropriate candidates for these future targeted therapies.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Cathepsin D* ; Cathepsins* ; Cytosol ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stromal Cells* ; Virulence

BACKGROUND: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. METHODS: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. RESULTS: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). CONCLUSIONS: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins ; Medical Records ; Motor Activity ; Pneumothorax ; Retrospective Studies ; Subclavian Vein ; Vascular Access Devices ; Vena Cava, Superior ; Venous Thrombosis

We found an error in this article. The author's affiliation.

Eosinophilia is defined as the presence of more than 500 eosinophil/mL of blood and is common in the clinical condition such as parasite infestation, drug, allergy, hypereosinophilic syndrome, and malignant diseases. Determining the cause of eosinophilia may be one of the most frustrating endeavors in clinical medicine. Hepatic infiltration of eosinophils and microabscess formation are observed in many disorders. Gastric cancer and intestinal malignancies show frequent liver metastasis and blood eosinophilia. Several cases of an early gastric carcinoma (EGC) with metastasis of the liver have been reported. When multiple intrahepatic lesions of suspicious malignancy appear in radiologic study, clinicians must differentiate malignancy from benign diseases. A case is herein reported of a 56- year-old male patient with synchronously developed, multiple low density hepatic lesions with early gastric carcinoma. He was managed with systemic chemotherapy at another hospital, because he was diagnosed with distant metastasis of early gastric carcinoma. Upon operating these lesions were proved to be EGC combined with hypereosinophilic multiple liver abscesses. This case is herein reported with a review of relevant literatures.
Clinical Medicine ; Drug Therapy ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome ; Hypersensitivity ; Liver Abscess* ; Liver* ; Male ; Neoplasm Metastasis ; Parasites ; Stomach Neoplasms

Polyarteritis nodosa is a systemic vasculitis that affects mainly small and medium-sized muscular arteries. About half of the cases, it involves gastrointestinal tract, mainly jejunum and ileum. Major clinical manifestations are bleeding, ulcer, infection, necrosis, atrophy and stricture. Gastrointestinal involvement suggests a poor prognosis. We have experienced one case of polyarteritis nodosa involving entire gastrointestinal tract that showed various endoscopic features and confirmed by renal biopsy.
Arteries ; Atrophy ; Biopsy ; Colon ; Constriction, Pathologic ; Duodenum ; Gastrointestinal Tract* ; Hemorrhage ; Ileum ; Jejunum ; Necrosis ; Polyarteritis Nodosa* ; Prognosis ; Systemic Vasculitis ; Ulcer