PURPOSE: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. MATERIALS AND METHODS: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. RESULTS: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. CONCLUSION: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.
Extremities ; Foot ; Forearm ; Hand ; Head ; Hemangioma ; Logistic Models ; Neck ; Recurrence ; Risk Factors

Osteomyelitis caused by nontuberculous mycobacterium (NTM) is rare in immunocompetent children, and is often difficult to differentiate from a bone tumor, juvenile rheumatoid arthritis, soft-tissue inflammation and subacute osteomyelitis. We report NTM osteomyelitis in immunocompetent children that developed at the left distal femoral epiphysis in a 24-month-old boy and at both tali in a 7-year-old boy.
Arthritis, Juvenile Rheumatoid ; Child ; Epiphyses ; Humans ; Inflammation ; Nontuberculous Mycobacteria ; Osteomyelitis ; Preschool Child

OBJECTIVE:To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. MATERIALS AND METHODS: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. RESULTS: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. CONCLUSION: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.
Bile Acids and Salts/physiology ; Biodegradation ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning/*instrumentation ; Phantoms, Imaging ; *Polyurethanes ; *Stents ; Support, Non-U.S. Gov't ; Tensile Strength ; Time Factors

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

BACKGROUND: Hypertension is the most common cause of left ventricular hypertrophy(LVH). Increased left ventricular mass(LVM) carries independent risk for congestive heart failure, coronary artery disease, sudden death, reduction of coronary reserve. The importance of treatment in systemic hypertension for cardiovascular morbidity and mortality has been estabilished. Regression of LVM occurs with a number of antihypertensive drugs. This study was designed to explore the relation between blood pressure control, LVM and left ventricular filling dynamics. METHODS: Twenty five patients (12 men, 13 women) with estabilished hypertension were studied. No patients had a previous history of antihypertensive therapy. We obtained the basal echocardiography at the diagnosis which were disclosed no definite LVH, and the follow-up echocardiography after 6 months antihypertensive therapy with angiotension converting enzyme inhibitor, fosinopril, in patients with untreated essential hypertension. RESULTS: 1) Baseline blood pressure was 150/125mmHg and fell to 104/85mmHg (p<0.001). There was no siginificant reduction in heart rate. LVM were reduced from 153gr/m2 to 129gr/m2. 2) Peak E velocity and Peak A velocity was 82.9cm/sec, 74.9cm/sec and reduced to 67.2cm/sec, 62.3cm/sec, (p<0.001). 3) Time velocity integral dimension E (Ei) and time velocity integral dimension A (Ai) was 13.0cm, 9.0cm and reduced to 8.6cm, 4.5cm respectively. But there was no significant inteval change in peak E/A velocity. Ei/Ai was increased from 1.7 to 2.1 (p<0.01). CONCLUSIONS: These results suggested that antihypertensive therapy with ACE inhibitor for 6 months reduced significantly the left ventricular mass in patients with untreated essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Coronary Artery Disease ; Death, Sudden ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Fosinopril ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Male ; Mortality

Intramural pregnancy is one of the rarest form of ectopic pregnancy that only 20 cases have been reported in the world so far. Pathologically, the location of the gestational sac is completely isolated from the uterine cavity and entirely surrounded by myometrium without any contact of endometrium. Many reports noted that there would be possible relationship between the intramural pregnancy and prior uterine traumatic factor- curettage, cesarean section, myomectomy, salpingectomy, and manual removal of the placenta and so on. We have recently experienced a case of intramural pregnancy following curettage, managed completely by the laparoscopic excision and additive single dose intramuscular MTX treatment. So, we report this case with a brief review of the literature.
Animals ; Cesarean Section ; Curettage ; Endometrium ; Female ; Gestational Sac ; Mice ; Myometrium ; Placenta ; Pregnancy* ; Pregnancy, Ectopic ; Salpingectomy

BACKGROUND AND OBJECTIVES: Corrected transposition of the great arteries (C-TGA) is a rare congenital heart disease, of which prognosis depends on the associated cardiac defects, systemic ventricular function, competency of atrioventricular valves, and the presence of conduction disturbances. This study was aimed to assess the midterm follow-up status of C-TGA. PATIENTS AND METHODS: Retrospective review was performed on 89 cases with C-TGA and two ventricles of adequate size, which were diagnosed between January 1980 and June 1997. RESULTS: Study subjects consisted of 56 males and 33 females (average age at diagnosis, 9 months). Mean follow-up duration was 98 months (range, 2 months - 23 years 8 months). Based on the associated cardiac anomalies, there were 6 simple C-TGA and 83 complex C-TGA patients. Surgery including 19 palliative and 47 corrective operations was attempted on 61 cases at mean age of 69 months. Tricuspid regurgitation (TR) was noted at the time of first examination in 52 (mild in 39; moderate in 8; severe in 5) and progressed in 18 patients. TVR was done on 5 patients and double switch on 7 patients. Arrhythmia was noted preoperatively (complete AV block in 3) in 11 and postoperatively (postoperative complete AV block in 3) in 22 patients. A total of 13 cases died including 10 perioperative deaths during follow-up. Actuarial survival rate at 10 year was 84.5%. CONCLUSION: In this study, the midterm outcome of corrected TGA is acceptable. However, long-term follow-up is required in respect to the function of atrioventricular valve and the systemic ventricle.
Arrhythmias, Cardiac ; Arteries* ; Atrioventricular Block ; Child* ; Diagnosis ; Female ; Follow-Up Studies* ; Heart Defects, Congenital ; Humans ; Male ; Prognosis ; Retrospective Studies ; Survival Rate ; Tricuspid Valve Insufficiency ; Ventricular Function

BACKGROUND/AIMS: This study compared the efficacy and safety of combined peginterferon alfa (PEG-IFN) and ribavirin with that of combined interferon alpha (IFN-alpha) and ribavirin, according to the treatment duration in Korean patients with chronic hepatitis C. METHODS: Medical records of 86 patients treated with PEG-IFN and ribavirin (mean age, 50.7 years; males/females, 57/29; genotypes 1/2, 59/27) and 134 patients treated with IFN-alpha and ribavirin (mean age, 50.9 years; males/females 74/60; genotypes 1/2, 79/55) were reviewed. Ribavirin was administered at doses of 600-1,200 mg and 600-800 mg in patients with genotypes 1 and 2, respectively. RESULTS: Sustained virological responses (SVRs) were evident in 68.4% and 41.7% of genotype 1 patients treated for 48 weeks in the PEG-IFN and IFN-alpha groups, respectively (P=0.021), and in 94.1% and 64.9% of genotype 2 patients treated for 24 weeks (P=0.026). Some genotype 1 patients treated for 24 weeks in the PEG-IFN group, who all exhibited negative HCV PCR results at week 12, showed an SVR of 87.5% (7/8). CONCLUSIONS: The rate of SVRs in Korean patients with chronic hepatitis C was higher for combined PEG-IFN and ribavirin than for combined IFN-alpha and ribavirin. Further study is needed to clarify the outcome of short-term therapy in patients with a rapid or early virological response.
Adult ; Aged ; Antiviral Agents/*administration & dosage ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/genetics ; Hepatitis C, Chronic/*drug therapy/genetics ; Humans ; Interferon Alfa-2a/*administration & dosage ; Interferon Alfa-2b/*administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols/*administration & dosage ; RNA, Viral/blood/genetics ; Retrospective Studies ; Ribavirin/*administration & dosage ; Treatment Outcome

BACKGROUND: Intrauterine surgical intervention for certain cardiac anomalies may have a therapeutic advantage over postnatal repair or palliation. However, it is essential to establish methods for intrauterine extracorporeal circulation and myocardial preservations which can maintain the hemodynamics and gas exchange in fetal lamb perioperatively. This study was aimed to observe the changes in hemodynamics and gas exchange according to the methods of fetal cardiac bypass. METHODS: Twelve fetal lambs (4.5 5.2 kg) at 120 to 150 days of gestation under ketamine anesthesia were subjected to cardiac bypass for 30 minutes. Six served as a group in which placenta was excluded from the extracorporeal circulation by clamping the umbilical cord during the bypass (the oxygenator group) and in the remaining six, the placenta worked as an in vivo oxygenator (the placenta group). The fetuses were observed every 10 minute during a 30-minute bypass and 30-minute post bypass period. The hemodynamic variables and fetal blood gases were measured at specific intervals. RESULTS: In the oxygenator group, mean arterial pressure (MAP), PaO2, heart rate and bypass flow rate were 62 to 74 mmHg, 220 to 282 mmHg, 169 to 182 /min and 134 to 164 ml/kg/min, respectively during bypass. But rapid deterioration of fetal cardiac and placental gas exchange function was observed following cessation of bypass. In the placenta group, MAP decreased from 61 to 34 mmHg and PaCO2 progressively increased from 56 to 74 mmHg during bypass. Flow rate was suboptimal (74 to 115 ml/kg/min) during bypass. All hearts of the placenta group was fibrillated immediately after discontinuation of bypass. CONCLUSION: The both methods of CPB, use of oxygenator and placenta as gas exchanger, under only ketamine anesthesia did not provide adequate hemodynamics and gas exchange without additional treatment for protection placental reaction. The methods of fetal cardiac bypass using either neonatal membrane oxygenator or placental as an in vivo oxygenator caused severe placental dysfunction and blood gas abnormalities.
Anesthesia* ; Arterial Pressure ; Constriction ; Extracorporeal Circulation ; Fetal Blood ; Fetus ; Gases ; Heart ; Heart Rate ; Hemodynamics* ; Ketamine* ; Oxygen ; Oxygenators ; Oxygenators, Membrane ; Placenta ; Pregnancy ; Umbilical Cord

Low back pain is common during pregnancy and has been reported in as many as 56% of pregnant women.However, the incidence of symptomatic lumbar disc displacement in pregnancy is exceedingly rare, and anesthetic management is particularly important in such cases because the attending anesthesiologist and surgeon must consider the effects of the anesthesia, the patient's position, and surgery on the fetus.We administered an epidural anesthesia for percutaneous endoscopic lumbar discectomy at 35 weeks of gestation with the patient in the prone position.The patient maintained an uneventful pregnancy and delivered a healthy baby at 38 weeks of gestation
Anesthesia ; Anesthesia, Epidural ; Back Pain ; Diskectomy ; Displacement (Psychology) ; Humans ; Incidence ; Pregnancy ; Prone Position