No abstract available.
Sympathectomy

PURPOSE: Traditionally vascular reconstruction has been reserved for patients with limb threatening ischemia. So, the surgery for claudication has been discouraged by the fear of bypass graft failure, limb loss, and significant perioperative complication that may be worse than the natural history of the disease. However, in a minority of patients with claudication, the symptoms progress and a severe disability can result, which limit normal daily activities. In these patients intervention may be regarded as worthwhile. METHODS: To evaluate the benefit or risk of revascularization that performed in patients with disabling or incapacitating intermittent claudication, the clinical data of patients who underwent the revascularization for disabling claudication at Yeungnam University hospital were collected and analyzed retrospectively. RESULTS: From January 1990 to June 1999, 98 patients with disabling claudication were performed the surgical or interventional management (13.7% of all lower limb arterial disease registration in our unit). The patients were 93 males and 5 females ranging from 35 to 76 years of age. The mean age was 59, with the highest incidence among people in their 50s, followed by those in their 60s and then in their 70s. History of smoking was noted in 82.7% of the cases. The major arterial occlusive site were aortoiliac artery in 42 cases (42.9%), femoral artery in 23 cases (23.5%), iliofemoral artery in 13 cases (13.3%), popliteal artery in 4 cases (4.1%), tibial artery in 5 cases (5.1%) and multi-level occlusion in 11 cases (11.2%). The operative procedures for disabling claudication were bypass graft operation in 70 cases, thromboembolectomy in 5 cases, endarterectomy in 4 cases and percutaneous transluminal angioplasty (PTA) in 19 cases. Arterial bypass operations were aortobifemoral or aortobipopliteal bypass in 17 cases, iliofemoral bypass in 8 cases, femoropopliteal bypass in 16 cases, femorotibial bypass in 3 cases, popliteotibial bypass in 6 cases, axillobifemoral bypass in 7 cases and femorofemoral bypass in 13 cases. In 98.4% of the operative cases, the early outcome was good with 3 to 2 rating according to Rutherford criteria and cumulative 12, 24, 60-month primary and secondary patency rates were 83.3%, 76.4%, 71.3% and 87.8%, 86.3%, 81.8%. The operative mortality rates were 0% and no limb loss was noted in this series. CONCLUSION: In summary, arterial reconstruction for disabling claudication is noted as safe and durable procedure in some selective patients. Therefore, surgical intervention are valid treatment option in selected patients with disabling claudication.
Angioplasty ; Arteries ; Endarterectomy ; Extremities ; Female ; Femoral Artery ; Humans ; Incidence ; Intermittent Claudication* ; Ischemia ; Lower Extremity ; Male ; Mortality ; Natural History ; Popliteal Artery ; Retrospective Studies ; Smoke ; Smoking ; Surgical Procedures, Operative ; Tibial Arteries ; Transplants

PURPOSE: Rotter's nodes are removed in the course of a radical mastectomy, however they are not routinely removed in a modified radical mastectomy and breast conserving surgery, although they can be. Having been relatively ignored, the prognostic value and correlation of Rotter's nodes with axillary nodal status have rarely been reported or systematically studied. The aims of the present study were to assess the frequency and pattern of Rotter's node metastasis in breast cancer patients, and to compare the incidence of axillary lymph node metastasis and Rotter's node. We also investigated the rate of skip metastasis. METHODS: In order to investigate the predictability of axillary node positivity, we compared the status of axillary lymph nodes and the pathological prognostic markers. In 580 consecutive mastectomies performed for breast carcinomas between 1987 and 1999, axillary and Rotter's nodes were routinely dissected and separately sampled during mastectomy. RESULTS: The mean number of axillary lymph nodes and Rotter's nodes were 19.5 and 0.9. Axillary lymph nodes metastases were found in 47.2% of all patients. The frequency of axillary lymph node metastasis and the involvement of a higher level of axillary lymph node were significantly increased with increasing tumor size. However, metastasis at Rotter's nodes did not follow this pattern. Rotter's nodes were anatomically present in 39.8% of patients and an average of 2.3 lymph nodes was found in the interpectoral region. Rotter's metastases were found in 5% of all patients, and 10.6% of those with axillary lymph node metastases. The number of Rotter's nodes metastases was higher as the metastases were found at a higher level (p<0.05). CONCLUSION:The presence of axillary metastases was related to histologic grade, nuclear grade and lymphovascular invasion, but was not related to the mitotic index or perineural invasion. It is apparent that the potential risks from Rotter's and skip metastases were not great in all patients, although the routine excision of Rotter's nodes should be applied to patients with more locally advanced disease (T2-3, N1-N2).
Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Lymph Nodes ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mitotic Index ; Neoplasm Metastasis

PURPOSE: Surgical axillary dissection to determine the status of nodes remains as a part of the standard operation in the management of breast cancer. Rotter's nodes are removed in the course of a radical mastectomy but they are not routinely removed in a modified radical mastectomy and breast conserving surgery, although they can be. Having been relatively ignored, the prognostic value and correlation of Rotter's nodes with axillary nodal status have been rarely reported or systematically studied. The aim of the present study was to access the frequency and pattern of Rotter's node metastasis in breast cancer patients, and compare the incidence of axillary lymph node metastasis and Rotter's node. We also investigated the rate of skip metastasis. MATERIALS AND METHODS: To investigate the predicting axillary node positivity, we compared the status of axillary lymph node and pathological prognostic markers. In 580 consecutive mastectomy performed for breast carcinomas between 1987 to 1999, axillary and Rotter's node were routinely dissected and separately sampled during mastectomy . RESULTS: The mean number of axillary lymph node and Rotter's nodes were 19.5 and 0.9. Axillary lymph nodes metastases were found in 47.2% of all patients. Frequency of axillary lymph node metastasis and involvement of higher level of axillary lymph node were significantly increased by increasing tumor size. But metastasis at Rotter's nodes was not following this pattern. Rotter's nodes were anatomically present in 39.8% of patients and average 2.3 lymph nodes were found in the interpectoral region. Rotter's metastases were found in 5% of all patients, and 10.6% of those with axillary lymph nodes metastases. Number of Rotter's nodes metastases were higher as the metastases were found to higher level(P<0.05). CONCLUSION: The presence of axillary metastases were related to histologic grade, nuclear grade and lymphovascular invasion, but not related to mitotic index and perineural invasion. In summary, number of axillary lymph node and metastatic rate of axillary lymph nodes were similar to western reports. It is apparent that potential risk from Rotter's and skip metastases were not great in all patients, but routine excision of Rotter's nodes should be applied to patients with more locally advanced disease.
Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Lymph Nodes ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mitotic Index ; Neoplasm Metastasis

PURPOSE: Rotter's nodes are removed in the course of a radical mastectomy, however they are not routinely removed in a modified radical mastectomy and breast conserving surgery, although they can be. Having been relatively ignored, the prognostic value and correlation of Rotter's nodes with axillary nodal status have rarely been reported or systematically studied. The aims of the present study were to assess the frequency and pattern of Rotter's node metastasis in breast cancer patients, and to compare the incidence of axillary lymph node metastasis and Rotter's node. We also investigated the rate of skip metastasis. METHODS: In order to investigate the predictability of axillary node positivity, we compared the status of axillary lymph nodes and the pathological prognostic markers. In 580 consecutive mastectomies performed for breast carcinomas between 1987 and 1999, axillary and Rotter's nodes were routinely dissected and separately sampled during mastectomy. RESULTS: The mean number of axillary lymph nodes and Rotter's nodes were 19.5 and 0.9. Axillary lymph nodes metastases were found in 47.2% of all patients. The frequency of axillary lymph node metastasis and the involvement of a higher level of axillary lymph node were significantly increased with increasing tumor size. However, metastasis at Rotter's nodes did not follow this pattern. Rotter's nodes were anatomically present in 39.8% of patients and an average of 2.3 lymph nodes was found in the interpectoral region. Rotter's metastases were found in 5% of all patients, and 10.6% of those with axillary lymph node metastases. The number of Rotter's nodes metastases was higher as the metastases were found at a higher level (p<0.05). CONCLUSION: The presence of axillary metastases was related to histologic grade, nuclear grade and lymphovascular invasion, but was not related to the mitotic index or perineural invasion. It is apparent that the potential risks from Rotter's and skip metastases were not great in all patients, although the routine excision of Rotter's nodes should be applied to patients with more locally advanced disease (T2-3, N1-N2).
Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Lymph Nodes ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mitotic Index ; Neoplasm Metastasis

Hepatobiliary fibropolycystic disease is cause of hepatosplenomegaly & portal hypertension. This disease entities was composed of polycystic liver disease, congenital hepatic fibrosis, choledochal cyst, Caroli's disease(communicating, cavernous biliary ectasia), & von Meyenburg's complex. Clinical symptoms are space occupying lesion, portal hypertension, & cholangitis. The pathogenesis of hepatobiliary fibropolycystic disease is unknown. Two theories has been suggested. In one, the basic defect is attributable to malformation of the embryonal ductal biliary plates. In the other theory, cyst formation occurs because of an abnormal pancreaticobiliary junction with resultant chronic pancreatic reflux into the biliary tree. We report a case of fibropolycystic disease with review of the literature.
Biliary Tract ; Cholangitis ; Choledochal Cyst ; Fibrosis ; Hypertension, Portal ; Liver Diseases

Portal vein thrombosis is a rare condition occuring in association with a wide varitey of precipitation factors. Among these, advanced hepatoma constitute the major etiology of portal vein thrombosis. Noncancerous intrahepatic portal vein occlusion was reported in some cases of repeated cholangitis. Generally, Intrahepatic stones occures in Lt. lobe of liver and repeated inflammatory precesses occlude peripheral branch of Lt. portal vein. So, noncancerous Rt. portal vein occlusion is extremly rare condition. Two Patients visited our hospital with Rt. upper quadrant abdominal pain and fever. Preoperative abdominal ultrasonography, computerlized tomography, endoscopic retrograde cholagiopancreaticography revealed multiple Rt. intrahepatic stones and Rt. portal vein 1st branch occlusion. Rt. lobectomy of liver were performed. Pathologic reports were portal vein occlusion due to inflammatory thrombi, not tumor thrombi. Thus authors experienced 2 cases of Rt. portal vein 1st branch occlusion due to noncancerous benign condition, such as multiple intrahepatic stones, we report these cases with brief review of literature.
Abdominal Pain ; Carcinoma, Hepatocellular ; Cholangitis ; Fever ; Humans ; Liver ; Portal Vein* ; Ultrasonography ; Venous Thrombosis

No abstract available.
Abscess* ; Anti-Bacterial Agents* ; Bacteria, Anaerobic*

No abstract available.

PURPOSE: This study was a retrospective evaluation of the correlation between the MVD (microvessel density) stained by anti-CD34 monoclonal antibodies, the expressions of p53 and Ki67 in gastric adenocarcinomas. The relationship between these markers and several clinicopathological parameters, if any, were also sort. METHODS: The study was performed on 82 patients diagnosed with gastric cancer, and operated on between July, 2000 and June, 2001. No neoadjuvant chemotherapy or radiation therapy was administered. Immunohistochemical staining was performed with monoclonal antibodies to CD34, p53, and Ki67 (DAKO, Copenhagen, Denmark). Independent t- and ANOVA tests were used to find any clinical correlation between the clinical parameters and MVD, from the immunohistochemical staining of the p53 and Ki67. A probability value (P value) less than 0.05 was considered as statistically significant. RESULTS: The mean values of MVD, p53 and Ki67 expressions (mean value+/-SD) were 38.5+/-15.2, 2.1+/-1.3, and 3.3+/-0.6, respectively. The maximal/minimal values were 153/4, 5/0 and 5/2. There was no apparent correlation found between the expressions of MVD, p53 and Ki67. Also, there was no correlation between the immunohistochemical staining and the clinicopathological parameters, such as age, sexual distribution, histological differentiation, N category and TNM stage. However, according to the depth of tumor invasion (T category), the MVD was found to be moreincreased in the early gastric adenocarcinomas (T1) than in advanced gastric adenocarcinomas (T2-4)(P=0.014). CONCLUSION: There was no apparent correlation between the expression of p53 and Ki67, or the clinicopathological parameters, such as age, sex, histological differentiation, T category, and N category and TNM stage. MVD was higher in the early gastric adenocarcinomas than in advanced gastric adenocarcinomas but further studies will be required to evaluate whether the MVD is a reliable prognostic factor in gastric adenocarcinomas.
Adenocarcinoma* ; Antibodies, Monoclonal ; Drug Therapy ; Humans ; Microvessels* ; Retrospective Studies ; Stomach Neoplasms