Femorofemoral bypass was chosen as a primary(n=71) and redo (n=7) procedures for 78 patients with unilateral iliac artery occlusive disease during the period of 4 and a half years at the Department of Surgery, Kyungpook National University Hospital. The patients were categorized into 3 groups according to the patency of the superficial femoral artery on the recipient-side leg and the performance of concomitant leg arterial bypass: Group I (n=34), patent superficial femoral artery (SFA); Group II (n=19), occluded SFA left untreated; Group III (n=25), occluded SFA treated with leg arterial bypass. Adjuvant procedures during the femorofemoral bypasses included 16 femoral endarterectomies, 5 donor-side iliofemoral interposition grafts, and 4 donor-side iliac balloon angioplasties. The primary cumulative patency rates for all femorofemoral bypasses at 1, 2, 3, and 4 years were 96.3%, 84.7%, 84.7%, and 74.2%, respectively calculated by the life table method. The primary patency rates were 90.0%, 62.9%, 62.9%, 62.9% in Group II and 95.7%, 89.5%, 89.5%, 89.5% in Group III at 1, 2, 3, and 4 years after bypass grafting. The statistical analysis with log rank test to compare the patency rates between Group II and III revealed no significant (p=0.2425) differences. In summary, femorofemoral bypass was a durable bypass procedure for the patients with unilateral iliac artery occlusion. Further follow-up is required to confirm the effects of concomitant leg arterial bypass to the patency of femorofemoral bypass.
Angioplasty ; Endarterectomy ; Femoral Artery ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Iliac Artery ; Leg ; Life Tables ; Transplants

Protein-calorie malnutrition is common in CAPD patients and is associated with increase in morbidity and mortality in CAPD patients. There are many causes of malnutrition in CAPD patients, and it is well known that a large amount of protein losses through peritoneal membrane is one of them. To investigate the effect of the peritoneal membrane transport characteristics on the nutritional status in long-term CAPD patients, we conducted a cross- sectional study on clinically stable 115 patients (63 males and 52 females) who have been on CAPD for more than 2 years, and assessed nutritional status by subjective global assessment (SGA), biochemical, anthropometric and urea kinetic parameters. Patients were divided into 4 groups according to the results of standard peritoneal equilibration test (PET). The results were as follows: 1) The patients were divided into 4 groups according to the PET results: high transporter (n=16, 14%), high average transporter (n=38, 33%), low average transporter (n=50, 43%), and low transporter (n=11, 10%). 2) The mean age of the patients was 50.1+/-11.6 years (range, 19-75) with sex ratio (M:F) 1.2:1 and mean duration of dialysis was 57.5+/-27.8 months (range, 24-135). The mean body weight (Bwt) was 59.2+/-8.9kg, percent ideal body weight (%IBW) was 104.7+/-15.6%, %lean body mass (LBM)/Bwt was 82.1+/-11.1%, and malnourished patients by subjective global assessment (SGA) were 32.2% (38/115). 3) The mean BUN, creatinine, total protein, and albumin level of the patients were 54.5+/-13.1mg/dL, 12.3+/-3.0mg/dL, 6.7+/-0.8g/dL, and 3.8+/-0.6g/dL, respectively. 4) There were no significant differences in age, sex ratio, CAPD duration, peritonitis rate, %LBM/ Bwt, and SGA among the 4 groups. 5) Total protein (g/dL) and albumin (g/dL) levels in high transporters were 6.4+/-0.5, 3.5+/-0.4, respectively, and they were significantly lower than those of low transporters (7.2+/-0.6, 4.2+/-0.5) (P<0.05). 6) 24 hour dialysate protein (g/day) and albumin (g/day) losses were significantly higher in high transporters (8.10+/-1.85, 4.19+/-1.23) compared to those of low transporters (5.07+/-1.85, 2.78+/-0.99) (P<0.05). 7) The level of IGF-1 (ng/mL) was significantly lower in high transporters (150.5+/-86.2) compared to that of low transporters (310.3+/-162.1) (P<0.05). 8) The level of BUN (mg/dL), Cr (mg/dL) were also lower in high transporters (45.4+/-13.1, 10.1+/-2.0) than those of low transporters (61.6+/-18, 14.7+/-2.7), but there were no significant differences in Hct, total cholesterol, prealbumin, and transferrin among the 4 groups. 9) There were no statistically significant differences in Kt/Vurea, RRF, NPCR, dietary calorie and protein intakes among the 4 groups. 10) Anthrometric parameters such as TSF, BSF, MAC and LBM measured by three different methods (LBMCr, LBMimp, LBManthro) didn't show any significant differences among the 4 groups. In conclusion, increased peritoneal permeability may not adversely affect SGA and anthropometric status of long-term CAPD patients, although it is associated with lower serum albumin, creatinine, and IGF-1 level. Clinical significance of these findings remains to be elucidated.
Body Weight ; Cholesterol ; Creatinine ; Dialysis ; Humans ; Ideal Body Weight ; Insulin-Like Growth Factor I ; Male ; Malnutrition ; Membranes ; Mortality ; Nutritional Status* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Permeability ; Prealbumin ; Protein-Energy Malnutrition ; Serum Albumin ; Sex Ratio ; Transferrin ; Urea

No abstract available.

No abstract available.
Arteriovenous Fistula* ; Biopsy*

No abstract available.
Humans

No abstract available.
Brain Abscess* ; Brain* ; Vancomycin-Resistant Enterococci*

Tuberculosis of the skull bone tuberculosis is a very rare disease. We report a case occurring in a 52 year-old male was referred to us because of headache and painful swelling in the right frontal area. Plain chest x-ray revealed fibrous, streaky, nodular, patchy opacities in the LUL together with pleural effusion. Plain skull x-ray and CT scan demonstrated osteolytic lesion in the right frontal bone; scanning showed hot uptake by the right frontal area, and this corresponding to skll findings revealed by plain film. After frontal craniotomy the involved bone flap and epidural abscess were removed. Pafthologically, typical granulomatous inflammation was seens; this was composed of caseation necrosis, epithelioid cells and surrounding lymphocytes and plasma cells.
Craniotomy ; Epidural Abscess ; Epithelioid Cells ; Frontal Bone ; Headache ; Humans ; Inflammation ; Lymphocytes ; Male ; Middle Aged ; Necrosis ; Plasma Cells ; Pleural Effusion ; Rare Diseases ; Skull* ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Osteoarticular

PURPOSE: To correlate the CT findings of acute pyelonephritis with its outcome and with clinical data. MATERIALS AND METHODS: Thirty five contrast enhanced CT scans in patients diagnosed as suffering from acute pyelonephritis were retrospectively analyzed. Findings based on the morphology of perfusion defect in the renal parenchyma were classified as normal, focal wedge, multifocal wedge, focal mass, or mixed form composed of wedge and mass. These findings were correlated with clinical data such as degree of fever, leukocytosis, the period after antibiotic treatment during which fever was reduced, and the presence of pyuria in each group Analysis was then performed. RESULTS: Perfusion defects were seen in 23 of 35 cases, and their morphology was classified as follows; focal wedge (n=2), multifocal wedge (n=8), focal mass (n=4), and mixed form (n=9). Twelve cases (34.3%) showed no perfusion defect. The duration of fever was significantly prolonged in patients with focal mass form(p<.05). There was no significant correlation between the morphology of perfusion defect, bilaterality, and other clinical factors. CONCLUSION: The present study shows that the clinical course of the focal mass form of perfusion defect, as seen on CT, is different from that of other types. CT could be effective in predicting clinical progress and the outcome of treatment in cases of acute pyelonephritis.
Fever ; Humans ; Leukocytosis ; Nephritis ; Perfusion ; Pyelonephritis* ; Pyuria ; Retrospective Studies ; Tomography, X-Ray Computed*

BACKGROUND: The function of the p53 protein is known to regulate cell proliferation by inhibiting cells entering S phase, so DNA damaged cell proliferation is inhibited by apoptosis. p21 is a cyclin dependent kinase inhibitor induced by wild type p53, not mutant p53. Thus p21 is thought to mediate the signal of p53 induced by DNA damaged agents to arrest the cell cycle in G1 phase. p53 and p21 are expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis are important. OBJECTIVE: The purpose of this study was to analyze immunohistochemical expression of mutant p53 and p21 protein in melanocytic lesions. METHOD: 11 cases of intradermal nevus, 7 cases of junctional nevus and 6 cases of malignant melanoma were immunohistochemically stained with p53 and p21 monoclonal antibodies. RESULTS: 1. In intradermal nevus, the p53 was negative in 100% and the p21 was negative in 98%. These findings suggest that the composing cells of intradermal nevus is completely mature cell. 2. The positive rates of p53 and p21 in junctional nevus were 43% and 43%, respectively. The positive rates of p53 and p21 in malignant melanoma were 82% and 67%, respectively. CONCLUSION: If the expression of p21 is induced by p53 independent pathway, the cell cycle can be arrested in G1 phase, so the tumor cell proliferation is inhibited. But if the expressed p21 is mutated as p53, it means that the natural function of p21 disappears. More research is necessary about the nature of p21 which is expressed with mutant p53.
Antibodies, Monoclonal ; Apoptosis ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclins ; DNA ; G1 Phase ; Melanoma* ; Nevus* ; Nevus, Intradermal* ; Phosphotransferases ; Prognosis ; S Phase

A clinical and statistical observation was made on out-patients and in-patients admitted to the Department of Urology, Seoul National University Hospital for the past 24 years from 1954 to 1977. The observations were summarized as follows. 1. During the period, the total number of out-patients was 63,438 and that of in-patients, 6,028. 2. In the out-patients, lower urinary tract infections such as urethritis and prostatitis were the most common diseases regardless of the time period. 3. In the in-patient, the frequency of the disease has been changed with the lapse of time in the order of the occurrence. The interesting changes of the disease order related to the time period were noted as follows. 1954-1960 : genitourinary tuberculosis, urolithiasis, tumor, injury and congenital anomaly. 1961-1970 : urolitiasis, tumor, genitourinary tuberculosis, injury, infection and congenital anomaly. 1971-1977 : tumor. urolithiasis, genitourinary tuberculosis, congenital anomaly, injury and infection. 4. In 1977, 10 major diseases were tumor, ureteral stone, infertility, renal tuberculosis, B. P. H. hypospadias, varicocele, renal stone, scrotal injury and renal tumor 5. Major operations were performed on 4,122 cases during the period. Nephrectomy and ureterolithotomy were the most common operations. Recently, total cystectomy with ileal loop diversion, transurethral procedure and vasovasostomy, which require more skillful techniques, are increasing in number.
Cystectomy ; Female ; Humans ; Hypospadias ; Infertility ; Male ; Nephrectomy ; Outpatients ; Prostatitis ; Seoul* ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urethritis ; Urinary Tract Infections ; Urolithiasis ; Urology* ; Varicocele ; Vasovasostomy