A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.
Bone Marrow* ; Humans ; Infant Equipment ; Mandible ; Mandibular Reconstruction* ; Retrospective Studies ; Ribs ; Titanium ; Transplants ; Vertical Dimension

BACKGROUND: Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. MATERIAL AND METHOD: Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9+/-0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7+/-3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9+/-1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5%. Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5+/-11.6%, P<0.001) as compared with preoperative left ventricular ejection fraction(25.3+/-2.3%). The follow up period of out patient was 25.3 months. CONCLUSION: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.
Aortic Valve ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Counterpulsation ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Mammary Arteries ; Mortality ; Myocardial Infarction ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Saphenous Vein ; Stroke Volume ; Thallium ; Ventricular Dysfunction, Left* ; Ventricular Function, Left

No abstract available.

No abstract available.
Aortic Aneurysm* ; Humans ; Rupture*

No abstract available.
Drug Therapy* ; Family Practice* ; Humans ; Tuberculosis, Pulmonary*

No abstract available.
Humans ; Pregnancy, Twin*

No abstract available.
Abscess* ; Drainage*

BACKGROUND: The purpose of this study was to determine the cause of the axillary abnormalities seen in mammography and to evaluate the imaging characteristics of benign lymphadenopathy and lymphadenopathy associated with malignancy. METHODS: One hundred ninety-three (193) abnormalities seen mammographically were retrospectively reviewed and correlated with clinical diagnoses and pathologic results found in the medical records of patients treated from August 1997 to July 1998 at the National Medical Center. For each abnormality, the length, the margins and the presence of microcalcifications were noted. RESULTS: One hundred seventy-eight (178) patients had benigh lymphadenopathy and twelve patients had metastatic breast cancer. The mean lengths of lymph nodes in benign lymphadenopathy & metastatic breast cancer were 13.7 mm and 22 mm, respectively (p=0.0002). Fatty infiltrations of benign lymphadenopathy were seen 157 patients (88.2%) while eleven patients with metastatic breast cancers had nonfatty infiltration and one patient had fatty infiltration. Among the patient with benign lymphadenopathy circumscribed margins were observed in 167 patients (93.8%), microlobulated margins in 7 patients (3.9%), and obscured margins in 4 patients (2.2%), while among the patients with metastatic breast cancer circumscribed margins were seen in 6 patients, obscured margins in 3 patients, spiculated margins in 2 patients, and a microlobulated margin in 1 patient. No microcalcifications were found in lymph nodes. CONCLUSIONS: For benign lymphadenopathy the size of the abnormality was less than 13.7 mm and it had circumscribed margin and fatty center. On the other hand; homogenously dense (nonfatty) axillary lymph nodes were strongly associated with malignancy when axillary lymph nodes were longer than 22 mm with ill-defined or spiculated margins; therefore, a biopsy should be done to confirm malignancy in such cases.
Biopsy ; Breast ; Breast Neoplasms ; Diagnosis ; Hand ; Humans ; Lymph Nodes* ; Lymphatic Diseases ; Mammography ; Medical Records ; Retrospective Studies

BACKGROUND: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery (RGEA) in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. MATERIAL AND METHOD: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. CONCLUSION: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.
Arteries ; Cardiac Output, Low ; Cerebral Infarction ; Coronary Artery Bypass* ; Coronary Vessels* ; Gastroepiploic Artery* ; Hemorrhage ; Humans ; Mediastinitis ; Mortality ; Myocardial Infarction ; Reoperation ; Transplants

Purpose: Endoscopic breast surgery for patients with breast cancer was introduced for its superior cosmetic outcomes; it was initially studied in the field of breast-conserving surgery and, more recently, in robotic-assisted nipple-sparing mastectomy (NSM). The main purpose of this study was to investigate the feasibility and safety of endoscopic NSM (E-NSM) in patients with breast cancer by comparing E-NSM and conventional NSM (C-NSM). Methods: Between May 2017 and October 2020, we retrieved the records of 45 patients who underwent NSM with permanent silicone implants and divided them into the E-NSM group (20 patients) and the C-NSM group (25 patients), depending on the use of the endoscopic device.We also analyzed demographic information, pathology, operative time, and complications. Results: No significant differences were observed between the 2 groups based on demographic information, postoperative pathological data, mean length of hospital stay, and total number of complications. The mean preparation time for surgery was comparable between both groups. Compared to the C-NSM group, the E-NSM group had a significantly longer mean operative time and, subsequently, a significantly longer mean total operative time and number of complications. Conclusion The results showed that E-NSM was feasible and safe with a more inconspicuous incision in patients with breast cancer.