PURPOSE: Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center. MATERIALS AND METHODS: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified. RESULTS: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5+/-14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3+/-21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012). CONCLUSION: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
Arm* ; Arteriovenous Fistula ; Catheterization ; Central Venous Catheters ; Diabetes Mellitus ; Dialysis* ; Fistula ; Humans ; Male ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Transplants

STUDY DESIGN: The authors is to report the clinical and radiological results of proximal half corpectomy with one motion segment fusion in Denis type B burst fracture. OBJECTIVES: To evaluate the efficacy of proximal half corpectomy in Denis type B burst fracture of thethoracolumbar and lumbar spine. SUMMARY OF LITERATURE REVIEW: For the operative management of burst fracture, various mothods including posterior ligamentotaxis, posterolateral decompression, anterior decompression or combined were reported. Among the methods, anterior decompression by the corpectomy of fractured vertebral body and fusion with or without instrumentation is the one of the widely accepted method of treatment. However, anterior decompression by excision of whole vertebral body has the disadvantage of high complication rate due to the instability from the large defect and long length of bone graft. Moreover, two motion segments have to be sacrified, which is very important especially in thoracolumbar and lumbar area. Material and METHODS: 43 cases operated from 1989 to 1996 and the minimum follow up period was two years and compared with that of 48 cases who were treated by total corpectomy and two motion segment fashion from 1986 to 1989. RESULTS: Solid bony union was obtained in 43 cases within 6 months and no back pain was complained in 39 cases (93%) at last follow up. There was no significant difference between two groups in correction of anterior vertebral height and kyphotic angle. Length of bone graft was 3.0cm in half corpectomy group and was 6.3cm in total corpectomy group. Hardward breakage or graft collapse was not observed in proximal half corpectomy, while there were 5 cases in total corpectomy. CONCLUSION: Proximal half corpectomy and fusion of one motion segment in Denis type B burst fracture is believed to be a successful method which can minimize the fused level, increase the stability, preserve motion segment and reduce the complication.
Back Pain ; Decompression ; Follow-Up Studies ; Spine* ; Transplants

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

No abstract available.
Blood Platelets* ; Diagnosis* ; Flow Cytometry* ; Integrin beta3* ; Thrombasthenia*

Cockayne syndrome is a rare autosomal recessive disorder that results in postnatal growth failure and progressive neurological dysfunction. Associated clinical features are gait disturbance, progressive pigmentary retinopathy and other ocular anomalies such as cataracts and optic disk atrophy, sensorineural hearing loss, dental caries and cutaneous photosensitivity. The disease is clinically heterogeneous with a wide range in the type and severity of symptoms. We experienced a case of Cockayne syndrome in 13 year-old male, who had delayed development, hypophasia, characteristic physical appearance, cutaneous photosensitivity, dental caries. We reported the case with review of literatures.
Adolescent ; Atrophy ; Cataract ; Cockayne Syndrome* ; Dental Caries ; Gait ; Hearing Loss, Sensorineural ; Humans ; Male ; Optic Disk ; Retinitis Pigmentosa

No abstract available.
Hemorrhage*

No abstract available.
Brain Infarction* ; Brain* ; Nephrotic Syndrome*

No abstract available.