No abstract available.
Transplants*

BACKGROUND AND OBJECTIVES: The precise mechanism linking obesity and vascular disease is still unclear. Previous studies have demonstrated that the plasma levels of adiponectin, an adipose-derived hormone, decrease in obese subjects, and that hypoadiponectinemia are associated with ischemic heart disease. In this study, we investigated the determinant factors of plasma adiponectin concentration in healthy premenopausal women. SUBJECTS AND METHODS: We analyzed the plasma adiponectin concentrations in healthy, obese premenopausal women (n=37, BMI> or =25 Kg/m2) and in age-matched, healthy, non-obese premenopausal women (n=23, BMI<25 Kg/m2). The visceral and subcutaneous fat areas were measured by CT scan. RESULTS: Plasma levels of adiponectin in the obese subjects were lower than those in the non-obese subjects (3.24+/-1.08 vs. 4.90+/-2.06 microgram/ml, p<0.01). Significant, univariate, inverse correlations were observed between plasma adiponectin levels and visceral fat areas (r=-0.643, p<0.001), and between adiponectin levels and subcutaneous fat areas (r=-0.407, p<0.01). In univariate analysis, adiponectin was directly related to insulin sensitivity, hsCRP, triglyceride, HDL and LDL cholesterol. In multivariate analysis, visceral fat areas (beta=-0.483, p=0.001) and HDL cholesterol remained significantly related to plasma adiponectin concentrations (beta=0.283, p<0.05). CONCLUSION: These results suggest that HDL cholesterol and visceral fat mass were independently associated with plasma concentrations of adiponectin.
Adiponectin* ; Adipose Tissue* ; Atherosclerosis ; Body Fat Distribution* ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Lipoproteins* ; Multivariate Analysis ; Myocardial Ischemia ; Obesity ; Plasma* ; Subcutaneous Fat ; Tomography, X-Ray Computed ; Triglycerides ; Vascular Diseases

A ruptured distal lenticulostriate artery (LSA) aneurysm is detected occasionally in moyamoya disease (MMD) patients presented with intracerebral hemorrhage. If the aneurysm is detected in hemorrhage site on angiographic evaluation, its obliteration could be considered, because it rebleeds frequently, and is associated with poorer outcome and mortality in MMD related hemorrhage. In this case report, the authors present two MMD cases with ruptured distal LSA aneurysm treated by endovascular embolization.
Aneurysm* ; Arteries* ; Cerebral Hemorrhage ; Embolization, Therapeutic ; Hemorrhage ; Humans ; Mortality ; Moyamoya Disease*

BACKGROUND AND OBJECTIVES: Percutaneous intervention has become an established technique in the treatment of peripheral arterial obstructive disease. This study was performed to evaluate the procedural success and long-term outcome of percutaneous intervention of the superficial femoral artery (SFA), and to determine the factors that influence the long-term outcome. SUBJECTS AND MEHTODS: Eighty-eight consecutive lesions, in 76 subjects (mean age 65) with chronic lower limb ischemia and SFA obstruction, diagnosed with angiography were included in this study. The angiographic success was defined as residual stenosis <30% and the clinical success as an improvement by at least one clinical category. The clinical patency was defined as an absence of symptom recurrence and target lesion revascularization during the follow up period. The predictors of the outcome were also determined. RESULTS: Balloon angioplasty only was performed in 39 lesions and thrombolysis only in 2, whereas stenting was performed in 47 lesions. Seventy four of the 88 attempts (84%) at recanalization were angiographically successful, while 73 (83%) experienced clinical improvement. The twelve month patency was 67%. Critical ischemia (versus intermittent claudication)(relative risk 4.2, p=0.020) and renal failure (relative risk 4.1, p=0.016) were independent negative predictors of the patency. CONCLUSION: Percutaneous intervention of the SFA yielded a high procedural success rate, with an acceptable long-term outcome. Symptoms of critical ischemia and renal failure were predictive of a low long-term patency.
Angiography ; Angioplasty ; Angioplasty, Balloon ; Arterial Occlusive Diseases ; Constriction, Pathologic ; Femoral Artery* ; Follow-Up Studies ; Ischemia ; Lower Extremity ; Outcome Assessment (Health Care) ; Recurrence ; Renal Insufficiency ; Stents

BACKGROUND: Axillary osmidrosis is characterized by an unpleasant odor, profuse sweating, and in some instances, staining of clothes that may socially and psychologically impair affected individuals. Various types of surgical procedures have been developed for the treatment of axillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneous pulsed neodymium: yttrium-aluminum-garnet (Nd-YAG) laser treatment for the treatment of axillary osmidrosis. METHODS: Twenty-nine patients with axillary osmidrosis were included in this study. Patients were categorized according to the results of an axillary malodor grading system, and a subcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for the appropriate distribution of laser energy was determined using the iodine starch test (Minor's test) against a grid pattern composed of 2x2 cm squares. The endpoint of exposure was 300 to 500 J for each grid, depending on the preoperative evaluation results. The results were evaluated by measurement of axillary malodor both pre- and postoperatively using the grading system and iodine starch test. RESULTS: The average follow-up period was 12.8 months. Nineteen patients had a fair-to-good result and ten patients had poor results. The postoperative Minor's test demonstrated that there were remarkable improvements for patients with mild to moderate symptoms. Complications including superficial second degree burns (n=3) were treated in a conservative manner. A deep second degree burn (n=1) was treated by a surgical procedure. CONCLUSIONS: Subcutaneous pulsed Nd-YAG laser has many advantages and is an effective noninvasive treatment for mild to moderate axillary osmidrosis.
Aluminum ; Axilla ; Burns ; Follow-Up Studies ; Humans ; Iodine ; Lasers, Solid-State ; Odors ; Starch ; Sweat ; Sweating ; Yttrium

OBJECTIVE: The authors evaluated the feasibility and targeting accuracy of CT fluoroscopy (CTF)-guided catheter placement and aspiration of intracerebral hematoma (ICH)s. MATERIALS AND METHODS: Nine patients (mean age, 63.3 +/- 15.3 years) were treated by CTF-guided hematoma aspiration under local anesthesia. The targeting errors in the lesion center, volume of the aspirated hematoma, accuracy of the final catheter position, procedure time, and clinical outcomes were evaluated. RESULTS: All catheters were successfully placed in the center of the hematoma. The mean volume of the aspirated hematoma was 20.6 +/- 8.8 mL (pre-treatment, 44.7 +/- 20.1 mL; post-treatment, 24.1 +/- 13.8 mL). The average procedure time was 25.1 minutes (range, 18-32 minutes). In one case with a scanty residual hematoma, the catheter was removed at the end of the procedure. In the remaining eight cases, the catheter was left in the residual hematoma for drainage and all catheter tips were accurately located in the final position. There were no procedure-related complications, including rebleeding and infection. CONCLUSION: CTF-guided ICH aspiration is a feasible, quick, and accurate procedure which could substitute for stereotactic methods. The accurate catheter position provided by real-time observation enables an effective aspiration and drainage of hematomas.
Anesthesia, Local ; Catheters ; Cerebral Hemorrhage ; Drainage ; Fluoroscopy ; Hematoma* ; Humans

BACKGROUND AND OBJECTIVES: Previous studies have demonstrated that adipokines can have positive and/or negative effects on vascular function. In this study, we attempted to characterize the association of adipokines with endothelium-dependent vasodilation in healthy premenopausal women. SUBJECTS AND METHODS: Noninvasive pulse wave analysis coupled with provocative pharmacological testing with salbutamol was used to measure endothelium-dependent vasodilation in 60 healthy premenopausal women [37 obese women; body mass index (BMI) > or = 25 kg/m2, 23 age-matched non-obese women; BMI<25 kg/m2]. The lipid profile, fasting insulin, glucose, and C-reactive protein (CRP) concentrations in each patient were assessed via standard laboratory techniques, and plasma concentrations of various adipokines, such as adiponectin, leptin, resistin and TNF-alpha, were measured via enzyme immunoassays. RESULTS: In the obese group, higher leptin concentrations were significantly associated with impairments in endothelium-dependent vasodilation (r=-0.371, p=0.005). This association remained significant, even after adjustment for other risk factors (beta=-0.39, p=0.006). However, we determined that there was no significant correlation between endothelium-dependent vasodilation and these variables in the obese group and the control group. CONSLUSION: Increased plasma concentration of leptin was associated with impairment in endothelial function in obese premenopausal women, regardless of the metabolic and inflammatory disturbances associated with obesity.
Adipokines ; Adiponectin ; Albuterol ; Body Mass Index ; C-Reactive Protein ; Endothelium ; Fasting ; Female ; Glucose ; Humans ; Immunoenzyme Techniques ; Insulin ; Leptin* ; Obesity ; Plasma ; Pulse Wave Analysis ; Resistin ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vasodilation

BACKGROUND: To minimize the inflammatory reaction and improve healing, a new modified dermal substitute composed of an atelocollagen, chondroitin-6-sulfate, and amniotic membrane (AM) was applied to full-thickness skin defects in a pig. Atelocollagen was extracted from bovine skin, and two modified dermal substitutes were generated according to the cross-linking type. METHODS: The AM-collagen dermal substitutes were characterized and compared with currently used dermal substitutes in a pig skin defect model. There were five experimental groups: dehydrothermal (DHT) cross-linking atelocollagen with the AM on the top (AM-DHT), DHT and chemical cross-linking atelocollagen with the AM on the top (AM-DHT/chemical), Terudermis, Integra, and AlloDerm. After 3x3 cm full-thickness skin defects on the back of a pig were created, each dermal substitutes dermal substitutes was randomly grafted on the defects. Two weeks after grafting, autologous partial-thickness skin was over-grafted on the neodermis. The take rate of the dermal substitutes, skin, and histological sections were all assessed at 1, 2, and 4 weeks postoperatively. RESULTS: More rapid healing and a higher take rate were evident in the AM-DHT and Terudermis groups. Histological examination revealed fewer inflammatory cells and more fibroblast hyperplasia in these two groups. Four weeks after surgery, the amount of newly formed collagen was significantly more appropriate in the AM-DHT group. CONCLUSIONS: These observations provide supporting evidence that a newly developed amniotic-collagen dermal substitute may inhibit inflammatory reactions and promote wound healing.
Amnion ; Biological Dressings ; Chondroitin Sulfates ; Collagen ; Dermis ; Fibroblasts ; Hyperplasia ; Skin ; Skin, Artificial ; Transplants ; Wound Healing

OBJECTIVES: This study designed to find the differences of left ventricular (LV) geometry in acute myocardial infarction (AMI) between ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) and the occurrences of adverse outcome according to the LV geometry. METHODS: Comprehensive echocardiographic analyses were performed in 256 patients with AMI. The left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated. LV geometry were classified into 4 groups based on RWT and LVMI: normal geometry (normal LVMI and normal RWT), concentric remodeling (normal LVMI and increased RWT), eccentric hypertrophy (increased LVMI and normal RWT), and concentric hypertrophy (increased LVMI and increased RWT). Cox proportional hazards models were used to evaluate the relationships among LV geometry and clinical outcomes. RESULTS: Patients with NSTEMI were more likely to have diabetes mellitus, hypertension, heart failure, stroke and previous myocardial infarction. By the geometric type, patients with NSTEMI were more likely to have eccentric hypertrophy (n=51, 34.7% vs. n=24, 22.0%, P=0.028). There was no significantly different adverse outcome between STEMI and NSTEMI patients. Fifteen patients (5.9%, 7 female [46.7%]) died and the median duration of survival was 10 days (range, 1 to 386 days). Concentric hypertrophy carried the greatest risk of all cause mortality (hazard ratios, 5.83; 95% confidence interval, 1.04 to 32.7). CONCLUSION: NSTEMI patients had more likely to have eccentric hypertrophy but adverse outcome after AMI was not different between STEMI and NSTEMI patients. Concentric hypertrophy had the greatest risk of short term mortality.
Diabetes Mellitus ; Female ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Myocardial Infarction ; Proportional Hazards Models ; Stroke

Although myocardial stunning occurs in coronary artery disease, it has rarely been reported with hyperthyroidism. A 72-year-old woman presented with general weakness, shortness of breath and febrile sensation of 10 days duration. The serum thyroid hormone level was elevated. Serial EKGs showed significant ST elevation suggesting transmural ischemia, but coronary angiography was not significant. Echocardiography showed regional wall motion abnormality of apical hypokinesia, which was improved after medication for hyperthyroidism. We report this case as an example of myocardial stunning associated with hyperthyroidism.
Aged ; Coronary Angiography ; Coronary Artery Disease ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Humans ; Hyperthyroidism* ; Hypokinesia ; Ischemia ; Myocardial Stunning* ; Sensation ; Thyroid Gland