PURPOSE: Since the introduction of short vein bypass (SVB), many have reported its feasibility when long vein bypass (LVB) cannot be performed due to limited vein conduit. However, the presence of inflow-vessel disease may affect graft patency and thus require endovascular treatment prior to surgery. Our study aims to analyze the results between SVB and LVB. MATERIALS AND METHODS: From 2009 to 2013, 27 bypass procedures were reviewed retrospectively. Outcomes such as patency rate, postoperative ankle brachial index (ABI) and limb salvage rate between SVB and LVB were compared. Wound healing time and primary patency rate were analyzed and the former was also analyzed according to the respective angiosome and revascularization type. RESULTS: There were 11 males and 16 females and the mean age was 66.6+/-12.3 years. Twenty four patients had TransAtlantic Inter-Society Consensus (TASC) D and 3 patients had TASC C lesions below knee. The 1-year cumulative patency rate between SVB and LVB were 63% and 66%, P=0.627. The limb salvage rate (100% vs. 73%; P=0.280) and postoperative ABI (0.592 vs. 0.508; P=0.620) were higher in the SVB group than in the LVB group, although the differences were not significant. There was no difference in wound healing time by angiosomal revascularization type. In situ vein graft showed higher patency rate than reversed greater saphenous vein (75% vs. 61%; P=0.00) CONCLUSION: The results of SVB were similar to those of LVB. SVB is feasible in the setting of limited conduit availability, in combination with endovascular treatment in the presence of proximal lesions.
Ankle Brachial Index ; Consensus ; Extremities* ; Female ; Humans ; Ischemia* ; Knee ; Limb Salvage ; Male ; Retrospective Studies ; Saphenous Vein ; Transplants* ; Veins* ; Wound Healing

No abstract available.
Anemia, Hypoplastic, Congenital*

We attempted to investigate the effects of curricular change on a basic medical science, anatomy, based on academic achievements including Basic Medical Education Examination (BMEE). We performed an analysis between the academic years of 2011 and 2012. Independent-samples t-test for the academic achievements, paired-samples t-test for the promotion, and correlation analysis for the related subcategory of the anatomy based on the results of BMEE, which was done with SPSS 22.0. In this follow-up study for two academic years, the academic achievements decreased as the students went to the next grade under the changed curriculum of anatomy. The academic achievements decreased as the students went to the next grade in the academic year 2012 while it increased in 2011 (p<0.01). Although averages of school evaluations were similar between the academic years, the academic achievements were different from each other: it was higher in first BMEE for 2012, and in second BMEE for 2011 (p<0.05). Although the correlation was not found among school evaluations, first and second BMEE of 2011, the associations were seen both between school evaluations (p<0.01) and each BMEE (p<0.05), respectively, in 2012. These results suggested that professors of medical school should continue to lead the direction of the curriculum improvement and management depending on the academic achievement, and also to monitor all the processes, maintaining a quality of the assessment system although it might be difficult to be representative or generalize for all medial schools.
Curriculum ; Education, Medical* ; Educational Measurement ; Follow-Up Studies ; Humans ; Schools, Medical

No abstract available.
Child* ; Humans

The most common adverse effect of intravenous heparin is hemorrhage. Of the these, retroperitoneal hemorrhage and femoral neuropathy secondary to heparin anticoagulation has reported in 1966 for the first time by DeBolt and Jordan. We experienced a case of spontaneous retroperitoneal hemorrhage due to iliopsoas muscle hematoma in patient with myocardial infarction receiving intravenous heparin for a 3 days in therapeutic doses. The pathophysiology of iliopsoas muscle hematoma has not yet been cleared. But because of the possibility of large amount in volume, retroperitoneal hemorrhage has been known as a serious adverse effect that leads to the hypovolemic shock and death. In this article, we described the clinical manifestation, the importance of the early diagnosis and diagnostic clues and associated factors of the retroperitoneal hemorrhage in patient receiving intravenous heparin.
Early Diagnosis ; Femoral Neuropathy ; Hematoma* ; Hemorrhage* ; Heparin* ; Humans ; Jordan ; Myocardial Infarction* ; Shock

Polypoid endometriosis is a rare form of endometriosis. It is a benign variant but its radiologic findings trick clinicians into concern about the tumor being malignant. A 42-year-old patient with a history of dysmenorrhea and adenomyosis presented a 60 mm-sized mass in the Douglas pouch with irregular echogenicity. The patient went under the first surgery for tumor removal, and its histopathologic diagnosis was endometriosis. We started daily dienogest medication to suppress tumor recurrence, but after 10 months we decided to stop the medication due to the side effects. Four months after the cessation, a new tumor recurred and after few months of observation, we performed the second surgery of tumor removal and total hysterectomy because of adenomyosis. The tumor was located in the retroperitoneal space in the Douglas pouch with severe adhesions. After the second surgery, the tumor marker Cancer antigen-125 level was normalized and the histopathologic result was endometriosis, which we concluded as polypoid endometriosis.

PURPOSE: There are few reports about the natural history of patients with pseudoprecocious puberty due to autonomous ovarian cyst. We reviewed the clinical course of 7 patients who had autonomous ovarian cysts and signs of precocious puberty. METHODS: We retrospectively evaluated 7 children, aged 2.8 to 7.9 years, who were diagnosed with pseudoprecocious puberty due to autonomous ovarian cysts from November 2005 to May 2011. The follow-up durations ranged from 0.5 to 6.3 years. RESULTS: Four out of 7 patients showed elevated serum estrogen levels and all revealed prepubertal response of gonadotropin to GnRH stimulation at diagnosis. The size of the cysts was from 1.7 to 4.6 cm on pelvic ultrasound examination. After 1 to 3 months, the ovarian cysts disappeared in all patients. Three of the girls developed relapsing signs of precocious puberty (vaginal bleeding and breast budding). Two of them showed an increase in growth velocity and bone age due to recurrent ovarian cysts, and one of them was converted to true precocious puberty. CONCLUSION: In our cases, all patients with autonomous ovarian cysts resolved spontaneously. However, some showed frequent recurrence of ovarian cysts, and needed a longer follow up because of the possibility of conversion to true precocious puberty and signs of McCune-Albright syndrome.
Aged ; Breast ; Child ; Estrogens ; Female ; Fibrous Dysplasia, Polyostotic ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Natural History ; Ovarian Cysts ; Puberty ; Puberty, Precocious ; Recurrence ; Retrospective Studies

No abstract available.
Mycobacterium bovis* ; Prostatitis*

A murime monoclonal antibody (mAb) specific for the envelope glycoprotein gp120 of human immunodeficiency virus type-I (HIV-1) was chemically coupled to pokeweed antiviral protein (PAP) from Phytolacca americana. The immunotoxin was purified by FPLC using 5200 colum. The purified immunotoxin efficiently bound to HIV-infected T cells as evidenced by fluorescence-activated cell sorter analysis. The immunotoxin selectively killed human T lymphoid lines infected with HIV-lIIIB at less than 250 pM of the immunotoxin cells, while PAP or mAb alone did not have any significant effect on infected cells. The uninfected control T cell lines were not affected. Human cells infected with HIV-2 or other HIV-1 strains were not killed, suggesting that the killing depends completely on the antibody used for coupling. These in vitro results suggest that the PAP-mAb conjugate may be used to selectively remove cells expressing viral antigens from individuals infected with HIV.
Antigens, Viral ; Cell Line ; Glycoproteins ; HIV ; HIV-1 ; HIV-2 ; Homicide ; Humans* ; Immunotoxins ; Phytolacca americana* ; T-Lymphocytes*

PURPOSE: Finasteride is being used as a medical therapy of benign prostatic hyperplasia (BPH), but there are no appropriate selection criteria for finasteride therapy. Our objective was to determine the usefulness of finasteride according to histological nature of the BPH, as determined by the transrectal ultrasonography (TRUS) findings. MATERIALS AND METHODS: Forty-two patients with symptomatic BPH were treated with finasteride (5mg/day) for more than 6 months. The patients were categorized into two groups of 21, according to their TRUS findings: the stromal, and the glandular, component dominant groups. The changes in prostate volume (PV), transition zone volume (TZV) and transition zone index (TZI) of each group, following at least 6 months of finasteride treatment, were evaluated and compared. RESULTS: In the stromal group the PV, TZV and TZI decreased from 69.3 11.5cc to 65.6 9.3cc, 43.5 13.2cc to 40.8 8.8cc and 0.63 to 0.62, respectively, but these changes were not statistically significant. While, in the glandular group, the PV, TZV and TZI decreased from 67.4+/-26.7cc to 56.2+/-25.2cc, 43.9+/-24.9cc to 32.4+/-19.9cc, and 0.63 to 0.54 (P<0.05), respectively. There was a linear correlation, only in the glandular group, between the TZI and TZV reductions following finasteride therapy (R=0.47, p=0.009). CONCLUSIONS: We suggest the prediction of the histological nature of BPH, by TRUS, would be helpful prior to the initiation finasteride treatment for effective reduction in the prostate volume with BPH. The effective reduction in the volume of the prostate in BPH would be possible only in glandular component dominant patients, as discriminated by TRUS.
Finasteride* ; Humans ; Patient Selection ; Prostate ; Prostatic Hyperplasia* ; Ultrasonography*