Intra-Arterial Digital Subtraction Angiography(IADSA) was performed in 128 patients during 13-month period. Weexperienced the same advantages of IADSA over conventional film-screen angiography:(1) significant reduction incontrast material dose: 1/3 of the dose of conventional angiography, (2) reduced film cost: 18% of the cost ofconventional technique, (3) decreased need for selective catherization,(4) shortened examination time, and (5)more ready detection of cnntrast material.
Angiography ; Angiography, Digital Subtraction ; Humans

OBJECTIVE: Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. METHODS: Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. RESULTS: The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. CONCLUSION: The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.
Cadaver ; Femoral Artery ; Ligaments ; Obturator Nerve* ; Spine

PURPOSE: We evaluated the usefulness of Re-188 sulfur colloid for radiation synovectomy and therapy of intraperitoneal metastasis. MATERIALS AND METHODS: We investigated the labeling efficiency of Re-188 sulfur colloid on various conditions. The stability of Re-188 sulfur colloid was observed at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was rneasured by filtering with various pore size filters. Animal experiment was performed in mice and rabbits. RESULTS: The labeling efficiency of Re-188 sulfur colloid was 64,5+/-5.8% (n=5) at the conditions of sodium thiosulfate 40 mg, EDTA Na2.2H2O 0,8 mg, KReO4 0.8 mg at pH l. After purification, the radiochemical purity was higher than 99%. The stability of Re-188 sulfur colloid was high (>99%) at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was 0.3% (<1 micrometer), 11.2% (1~5 micrometer), 35.8% (5~10 micrometer) and 52.8% (>10 micrometer). In mice, 1 h postinjection of Re-188 sulfur colloid into tail vein, uptakes in lung, liver and muscle were 37.30+/-5.36, 32.33+/-5.79, 6.60+/-0.02% 1D/organ respectively. After I.p. injection in rnice, the uptakes of extraperitonial organs of Re-188 sulfur colloid at 1 and 24 h were 0.1+/-0.1, 0.4+/-0.1% ID/organ, and the excretions through urine and feces (~70 h) were low (2.68+/-0.80, 0.95+/-0.17%). When Re-188 sulfur colloid was injected to synovial space of rabbit, the uptake in other organs except knee was very low. CONCLUSION: Re-188 sulfur colloid showed high labeling efficiency, stability and potency for clinical use.
Animal Experimentation ; Animals ; Colloids* ; Edetic Acid ; Feces ; Humans ; Hydrogen-Ion Concentration ; Knee ; Liver ; Lung ; Mice ; Neoplasm Metastasis ; Particle Size ; Rabbits ; Sodium ; Sulfur ; Synovial Fluid ; Veins

A 70-year-old woman underwent cardiopulmonary bypass surgery for aorta dissection. After 10 days she developed a vertical gaze palsy, and 2 months later she presented with dysarthria, bradykinesia, postural instability, blepharospasm, and truncal tilt to the left. Brain imaging indicated old lacunes in the bilateral thalamus. Her symptoms remained unchanged during a 4-year follow-up, which seems to be incompatible with progressive supranuclear palsy (PSP). However, the clinical features of this case were suggestive of PSP-like syndrome after cardiopulmonary bypass surgery.
Aged ; Aorta* ; Blepharospasm ; Cardiopulmonary Bypass ; Dysarthria ; Female ; Follow-Up Studies ; Humans ; Hypokinesia ; Neuroimaging ; Paralysis ; Parkinsonian Disorders ; Supranuclear Palsy, Progressive ; Thalamus

No abstract available.
Adrenal Hyperplasia, Congenital*

This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Polydeoxyribonucleotides/*therapeutic use ; Pressure Ulcer/*drug therapy ; Treatment Outcome ; Wound Healing/*drug effects ; Young Adult

BACKGROUND AND OBJECTIVES: It is rare to find any studies reporting on the practical measurements of landmarks in the paranasal sinuses that are done intraoperatively as well as comparative analysis on the anatomical and radiological measurements of the paranasal sinuses. The aim of this study was to analyze the anatomical measurements of the paranasal sinuses using nasal endoscope and CT scout films to determine the statistical significance. MATERIALS AND METHODS: In 130 patients the authors used bayonet forceps and seekers to measure the distances from the anterior nares to some of the intranasal structures, such as the uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus. Then, using the CT scout films, we measured the distances between the anterior nasal spine and the basal lamella (B.L.), the anterior wall of sphenoid sinus (A.W.S.), and the posterior wall of sphenoid sinus (P.W.S.). We analyzed the mean values of the basal lamella, the anterior and posterior wall of sphenoid sinus from all the available data in order to compare the endoscopic and radiologic measurements, and carried out a paired t-test. RESULTS: There was a statistically significant discrepancy in the comparative analysis of the CT scout film and the endoscopic measurements of the basal lamella, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus, althought there were no significant discrepancy for basal lamella in female patients (p>0.05). CONCLUSION: The differnces between the CT and operative measurements observed in this study were due to differnt measuring points, differences in the measuring angles, and inaccurate locations of the landmarks on the CT scout films owing to their small sizes. These findings indicate that a more accurate method need to be introduced in using the CT films to measure the anatomical landmarks in the paranasl sinuses.
Endoscopes* ; Ethmoid Sinus ; Female ; Humans ; Paranasal Sinuses* ; Sphenoid Sinus ; Spine ; Surgical Instruments

Primary thyroid lymphoma is defined as a lymphoma involving either the thyroid gland alone or both the thyroid gland and neck lymph nodes, without contiguous spread or distant metastases from other areas of involvement at the time of diagnosis. Despite its rarity, prompt recognition of primary thyroid lymphoma is essential due to its distinct management, which differs significantly from the treatment approaches for other neoplasms of the thyroid gland. Herein, we report a 64 years old female patient who complained of hoarseness, and was diagnosed as thyroid lymphoma with unilateral vocal fold paralysis. After chemotherapy, vocal fold paralysis was relieved and the patient’s hoarseness improved.

Compared with iron dextran, iron chondroitin sulfate(ICS) is much cheaper and has better bioavailability. To evaluate the efficacy and safety of ICS in maintenance HD patients, i.v. ICS was given to 37 HD patients [20 M, 17 F, median age 51 years, median duration of HD 21 months] whose ferritin(Fer)< 100microgram/L or transferrin saturation(TFS) <20% [Group I , 12 M, 10 F] or Hb<9.0g/dL in spite of increased rHuEPO dose, Fer>or=100microgram/L and TFS>or=20% [Group II, 8 M, 7 F]. The patients had taken oral iron [227+/-73mg/day(mean+/-SD)] before this study. All patients received 120mg i.v. ICS weekly for 1 month. Then, ICS dosage was adjusted to 40-120mg/week depending on Hb, Fer and TFS in the following 3 months. Hb, Fer, TFS, rHuEPO dose and side effects were monitored monthly. The results were as follows : 1) I.v. iron therapy produced a significant rise in Hb(8.3+/-0.9g/dL to 9.7+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(95+/-50U/kg/wk to 69+/-28U/kg/wk; P<0.05), a significant increase in serum ferritin levels(162+/-149microgram/L to 472+/-255microgram/L; P<0.01) and TFS(24+/-13% to 41+/-18%; P<0.05). 2) In group 1, i.v. iron therapy produced a significant rise in Hb(8.5+/-1.1g/dL to 9.9+/-0.9g/dL; P< 0.01), a significant reduction in rHuEPO dose(87+/-45U/kg/wk to 69+/-27U/kg/wk; P<0.05), increased serum ferritin levels(90+/-48microgram/L to 379+/-186microgram/L; P<0.01) and TFS(18+/-9% to 36+/-16%; P<0.05). 3) In group 2, i.v. iron therapy produced a significant rise in Hb(8.1+/-0.6g/dL to 9.3+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(108+/-55U/kg/ wk to 69+/-31U/kg/wk; P<0.05) and increased serum ferritin levels(274+/-185microgram/L to 602+/-287microgram/L; P< 0.01) with a tendency of increase in TFS(35+/-13% to 41+/-18%; P=0.06). 4) No significant side effect was observed. 5) An annual cost reduction of 221 US dollars per patient was expected. In conclusion, ICS is an effective and safe intravenous iron preparation in HD patients.
Anemia ; Biological Availability ; Chondroitin ; Dextrans ; Erythropoietin ; Ferritins ; Humans* ; Iron* ; Kidney Failure, Chronic ; Transferrin

BACKGROUND: Facial rejuvenation can be achieved using a variety of techniques. Since minimally invasive procedures for face lifting have become popular because of their convenience and short operating time, numerous minimally invasive surgical procedures have been developed. In this study, a nonabsorbable polypropylene mesh is introduced as a new face lifting instrument, with the nasolabial fold as the main target area. In this paper, we report the efficacy and safety of a polypropylene mesh in midface rejuvenation. METHODS: Thirty-three subjects with moderate-to-severe nasolabial folds were enrolled from two medical institutions for a noncomparative single-sample study. A mesh was inserted above the superficial muscular aponeurotic system layer, reaching the nasolabial folds through a temporal scalp incision. After 3 weeks, the temporal end of the mesh was pulled to provide a lifting effect. Then, the mesh was fixed to the deep temporal fascia using nonabsorbable sutures. To evaluate efficacy, we compared the scores on the Wrinkle Severity Rating Scale and a visual analog scale for patient satisfaction between the baseline and 7 weeks postoperatively. In addition, we evaluated safety based on the incidence of adverse events. RESULTS: The treatment was deemed effective at improving wrinkles in 23 of 28 cases, and patient satisfaction improved significantly during the study period. There were seven cases of skin or subcutaneous tissue complications, including edema and erythema, but there were no suspected serious adverse events. CONCLUSIONS: Face lifting using a nonabsorbable mesh can improve nasolabial folds without serious adverse effects. Thus, this technique is safe and effective for midface rejuvenation.
Edema ; Erythema ; Fascia ; Incidence ; Lifting ; Nasolabial Fold ; Patient Satisfaction ; Polypropylenes* ; Rejuvenation* ; Rhytidoplasty ; Scalp ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Minimally Invasive ; Sutures ; Visual Analog Scale