Venous thrombectomy and temporary arteriovenous (AV) fistula are performed for the treatment of iliofemoral venous thrombosis. The theory behind creation of an AV fistula is to increase venous flow, thereby maintaining patency. But AV fistula might induce severe peripheral venous hypertension in the condition of proximal venous segment reocclusion. A 62-year-old woman who developed severe peripheral venous hypertension after postthrombectomy AV fistula visited our clinic. We treated this patient with simple ligation of the AV fistula.
Arteriovenous Fistula ; Female ; Fistula ; Humans ; Hypertension ; Ligation ; Middle Aged ; Thrombectomy ; Venous Thrombosis

The obturator foramen bypass has been described as an alternative procedure to solve complicated vascular problems in the groin. This extra-anatomical bypass has been used successfully in cases of infection, mycotic aneurysm, traumatic ulcer, irradiation ulcer, and excessively scarred tissues in the femoral region. We experienced two cases of iliopopliteal bypass through obturator foramen in femoral artery mycotic aneurysm and graft infection after femoral-femoral bypass.
Aneurysm, Infected ; Cicatrix ; Femoral Artery ; Groin ; Transplants ; Ulcer

Twenty patients with Buerger's disease who were not candidates for reconstructive arterial surgery were treated by PGE1(Lipo PGE1(R) ) for 1 Month. All patients were injected with 50microgram of alprostadil intravenously once a day. Clinical effects were evaluated by improvement of ischemic symptom and healing rate on gangrenous foot and side effects. Clinical efficacy by combined assessment of markedly improved, improved, slightly improved was 70%. 5 of 8 patient who had gangrenous foot showed improved healed state. Adverse effect was found in only one patient who had minimal gum bleeding. However there was no deterioration on chemical profile including CBC, liver function test, urinary analysis, CRP and ESR. The results suggest that Lipo PGE1(R) has a beneficial effect on Buerger's disease without significant adverse effect.
Alprostadil ; Foot ; Gingiva ; Hemorrhage ; Humans ; Liver Function Tests ; Thromboangiitis Obliterans

Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

A deep vein thrombosis(DVT) is responsible for a number of significant medical problems including pulmonary embolisms. The factors that cause DVT have been studied by many investigators. The cases of 31 DVT patients, 19 males and 12 females, who were treated from January 1994 through January 1996, were reviewed. The mean age was 47.3 15.9 years. Four cases(12.9%) affected the right leg, 25 cases(80.6%) on the left leg, and 2 cases(6.5%) the portal vein and the mesenteric vein. Among the 29 lower extremity DVT cases, 16 cases(51.6%) showed ipsilateral iliac vein thromboses and 1 case(3.2%) showed an inferior vena cava thrombosis. Five cases(16.1%) had a history of an explo-laparotomy, 2 cases(6.5%) had a history of immobilization, 1 case(3.2%) had a history of trauma to the involved leg, and 2 cases(6.5%) had a history of collagen disease. However, 21 cases(67.7%) had no history of any predisposing factors. Five cases(16.1%) were confirmed as protein C deficiency, 3 cases(9.7%) as protein S deficiency, 4 cases(12.9%) as antithrombin III deficiency, 3 cases(9.7%) as plasminogen deficiency, and 6 cases(19.4%) as -2 antiplasmin deficiency. Ten(32.3%) of the 31 cases had multiple coagulation factor deficiency. Three patients(9.7%) had been inserted with Greenfield filter into the inferior vena cava. Initially, unfractionated heparin was injected intravenously under the control of the activated partial thromboplastin time(aPTT) until the warfarin effect reached INR 1.75~2.0. Only 5 of the 31 cases agreed to a family to study to detect any possible coagulation factor abnormality. Three of these 5 families showed coagulation factor abnormality. Our results show that more extensive study on DVT is needed in the Korean population.
Antithrombin III ; Antithrombin III Deficiency ; Blood Coagulation Factors* ; Causality ; Collagen Diseases ; Female ; Heparin ; Humans ; Iliac Vein ; Immobilization ; International Normalized Ratio ; Korea* ; Leg ; Lower Extremity ; Male ; Mesenteric Veins ; Plasminogen ; Portal Vein ; Protein C ; Protein C Deficiency ; Protein S ; Protein S Deficiency ; Pulmonary Embolism ; Research Personnel ; Thromboplastin ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis* ; Warfarin

Mesenchymal stem cells (MSCs) are capable of self-renewal and differentiation into lineages of mesenchymal tissues that are currently under investigation for a variety of therapeutic applications. The purpose of this study was to compare cytokine gene expression in MSCs from human placenta, cord blood (CB) and bone marrow (BM). The cytokine expression profiles of MSCs from BM, CB and placenta (amnion, decidua) were compared by proteome profiler array analysis. The cytokines that were expressed differently, in each type of MSC, were analyzed by real-time PCR. We evaluated 36 cytokines. Most types of MSCs had a common expression pattern including MIF (GIF, DER6), IL-8 (CXCL8), Serpin E1 (PAI-1), GROalpha(CXCL1), and IL-6. MCP-1, however, was expressed in both the MSCs from the BM and the amnion. sICAM-1 was expressed in both the amnion and decidua MSCs. SDF-1 was expressed only in the BM MSCs. Real-time PCR demonstrated the expression of the cytokines in each of the MSCs. The MSCs from bone marrow, placenta (amnion and decidua) and cord blood expressed the cytokines differently. These results suggest that cytokine induction and signal transduction are different in MSCs from different tissues.
Bone Marrow Cells/*cytology ; Cytokines/genetics/*metabolism ; Female ; Fetal Blood/*cytology ; Gene Expression Profiling ; Humans ; Mesenchymal Stem Cells/cytology/*metabolism ; Placenta/*cytology ; Pregnancy ; Protein Array Analysis

In 1897, Poncet described polyarthritis in patients suffering from tuberculosis which was not caused by tuberculosis infection of the joints. Poncet's disease is characterized by a polyarthritis that occurs during the acute tuberculosis infection in which no mycobacterial involvement can be found or other known cause of polyarthritis detected. It is a different entity from tuberculous arthritis, which is usually monoarticular and is caused by direct tuberculous infection. It was little known for pathogenesis of Poncet's disease, but immunologic reaction was suggested. Poncet's disease is associated with an excellent prognosis with rapid resolution on commencing therapy and no sequelae. Therefore, recognition of Poncet's disease can be important. Poncet's disease remains a diagnosis of exclusion.Recently, we experienced one case of Poncet's disease which have characterized by the clinical manifestations, and report this case with a review of the literatures.
Arthritis ; Diagnosis ; Humans ; Intestines* ; Joints ; Lymph Nodes* ; Prognosis ; Tuberculosis*

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79+/-0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61+/-0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36months after treatment in F/U group(1.44+/-0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18+/-1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35+/-0.28) and Non F/U group(0.78+/-0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.
Allografts ; Autografts ; Bone Substitutes ; Follow-Up Studies ; Glass* ; Guided Tissue Regeneration ; Heterografts ; Humans ; Periodontal Diseases ; Regeneration ; Surgery, Plastic ; Transplants*

BACKGROUND: Because of widespread and long-term use of lead, many lead poisoning cases were reported. Especially, in Korea including Southeast Asia, we observed non-occupational lead poisoning cases by herbal medication. METHODS: We identified total 45 cases of lead poisoning through Medric search, from 1973 to 2002. Bibliographies of relevant articles were reviewed. We arranged cases by attributes following 1) reported year, 2) age, 3) sex, 4) exposure sources, 5) exposure duration, 6) clinical manifestation, 7) treatments. RESULTS: The average age of the patients was 41.4 +/- 15.7 year-old. The distribution by sex did not have difference each other. The non-occupational lead poisoning cases were mostly caused by Chinese herbal medication. On the cases of the herbal lead poisoning, average exposure duration was 7.3 +/- 3.8 months and the various dosages were taken from 5 mg to 3 g. The major clinical symptoms were abdominal pain, headache, and constipation. The typical laboratory finding was anemia. Major treatment agent was oral penicillamine. CONCLUSION: To differential diagnose of the lead poisoning from many diseases with similar symptoms is very difficult solely on the clinical aspect. Especially, in non-occupational cases it is more difficult. In Korea, non-occupational lead poisoning cases by herbal medication have been discovered more than in western countries. We reviewed about the lead poisoning cases since 1973, so we want to make an aware of scientific and rational making and management of lead in the health supplementary food and herbal medicine.
Abdominal Pain ; Anemia ; Asia, Southeastern ; Asian Continental Ancestry Group ; Constipation ; Headache ; Herbal Medicine ; Humans ; Korea* ; Lead Poisoning* ; Penicillamine