Transvenous endovascular treatment is the first choice for treating most cavernous sinus dural arteriovenous fistulas (CDAVFs). Among several available venous routes, the inferior petrosal sinus is the most commonly used. We report a case of CDAVF treated with endovascular treatment via the middle temporal vein (MTV). A 65-year-old man presented with unilateral chemosis and exophthalmos for approximately two months. Digital subtraction angiography showed a right CDAVF with predominant venous drainage toward the right superior ophthalmic vein. The superior ophthalmic vein primarily drained into the dilated MTV. Both sides of the inferior petrosal sinus were occluded; therefore, transvenous embolization was performed via the MTV route. The fistula was completely obliterated. The patient’s symptoms improved and the postoperative course was uneventful. The transfemoral approach via the MTV to treat CDAVF provides a crucial alternative when other venous routes are difficult or impossible to navigate with a catheter.

Objective: Variable treatment strategies and protocols have been applied to reduce time durations in the process of acute stroke management. The aim of this study is to investigate the effectiveness of our intra-arterial thrombectomy (IAT) protocol for decreasing door-to-recanalization time duration and improve successful recanalization. Methods: A systemic and endovascular protocol included door-to-image, image-to-puncture and puncture-to-recanalization. We retrospectively analyzed the patients of pre- (Sep 2012–Apr 2014) and post-IAT protocol (May 2014–Jul 2018). Univariate analysis was used for the statistical significance according to variable factors (age, gender, the location of occluded vessel, successful recanalization TICI 2b-3). Independent t-test was used to compare the time duration. Results: Among all 267 patients with acute stroke of anterior circulation, there were 50 and 217 patients with pre- and post-IAT protocol. Age, gender, and the location of occluded vessel have no statistical significance (p＞0.05). In pre- and post-IAT group, successful recanalization was 39 of 50 (78.0%) and 185/217 (85.3%), respectively (p＜0.05). Post-IAT (48.8%, 106/217) group had a higher tendency of good outcome than pre-IAT group (36.0%, 18/50) (p＞0.05). Pre- and post-IAT group showed 61.7±21.4 vs. 25±16.0 (p＜0.05), 102.0±29.8 vs. 82.7±30.4 (min) (p＜0.05), and 79.1±47.5 vs. 58.4±75.3 (p＜0.05) in three steps, respectively. Conclusions We suggest that the application of systemic and endovascular IAT protocols showed a significant time reduction for faster recanalization in patients with LVO. To build-up the well-designed IAT protocol through puncture-to-recanalization can be needed to decrease time duration and improve clinical outcome in recanalization therapy in acute stroke patients.

This is a cross-sectional study to evaluate the serum lipid levels of children living in Pusan in 1996. The distribution of age is from 2 years old to 12 years old. In female children mean total cholesterol is 171.4+/-26.2mg/dl, triglyceride is 104.7+/-50.6mg/dl, HDL-cholesterol is 54.4+/-14.8mg/dl, and LDL-cholesterol is 95.4+/-32.9mg/dl. In male children mean total cholesterol is 167.9+/-25.2mg/dl, triglyceride is 90.6+/-45.5mg/dl, HDL-cholesterol is 55.4+/-11.7mg/dll, and LDL-cholesterol is 94.4+/-23.6mg/dl. The percentile of serum lipid levels is measured in children. The 95th percentile of serum total cholesterol is 210mg/dl in male children, and 214mg/dl in female children. And, the 95th percentile of serum triglyceride is 184mg/dl in male children, and 191mg/dl in female children. And, the 95th percentile of LDL-cholesterol is 133mg/dl in male children, and 135mg/dl in female children. Serum total cholesterol is positively related to age(r=0.18), height(r=0.08), weight(r=0.17), obesity index(r=0.12), and negatively related to father's education level(r=-0.13), mother's education level(r=-0.13). Serum triglyceride is positively related to weight(r=0.23), age(r=0.31) and negatively related to father's education level(r=-0.12), mother's education level(r=-0.18). Serum HDL-C was positively related to mother's education level(r=0.07) and negatively related to height(r=-0.12), weight(r=-0.09). Conclusively, the serum lipid levels of children living in Pusan is generally so high that the family and school must try to control the serum lipid levels.
Busan* ; Child* ; Child, Preschool ; Cholesterol ; Cross-Sectional Studies ; Education ; Female ; Humans ; Male ; Obesity ; Triglycerides

BACKGROUND: It is a trend that the average life span is prolonged in proportion to the advance of socio-economy and medical science. Consequently, the number of elderly patients with skin diseases is increasing. OBJECTIVE: This study was performed to see the change of patterns of skin diseases in elderly patients. METHODS: One thousand four hundred and twenty elderly patients, over the age of 65, who visited the departments of dermatology and in five hospitals, from January 1, 1997 to December 31, 1997 were selected. We surveyed the frequeney of skin disease by types and the distributions by month, season and age.
Aged* ; Dermatology ; Epidemiologic Studies ; Humans ; Seasons ; Skin Diseases* ; Skin*

A case of symptomatic bilateral popliteal artery entrapment syndrome is reported. A twenty-one-year old male, a candidate of athlete, complained of coldness, weakness, pallor and cyanosis of right lower leg and intermittent claudication to both calves during walking or exercise for ten months. Studies revealed that the right popliteal artery was completely occluded, but the left popliteal artery was non-occlusive. An endarterectomy and onlay vein patch graft to the thrombosed and fibrotic right popliteal artery, and myotomies of bilateral medial heads of gastrocnemius muscle were done (May 20, 1998). Follow-up examinations for the last ten months showed a complete relief of symptoms with normal distal arterial flow. It is thought that even though the majority of patients present with unilateral calf claudication, the possiblity of bilateral problems need to be also considered.
Athletes ; Cyanosis ; Endarterectomy ; Follow-Up Studies ; Head ; Humans ; Inlays ; Intermittent Claudication ; Leg ; Male ; Muscle, Skeletal ; Pallor ; Popliteal Artery* ; Transplants ; Veins ; Walking

Carcinosarcomas of the esophagus are rare malignant neoplasms that consist of both carcinomatous and sarcomatous components, which comprise approximately 1~2% of all esophageal neoplasms. Usually, esophageal carcinosarcomas are the polypoid type, and patients with esophageal carcinosarcoma have progressive dysphagia. The multiplicity in terminology appears to be related to the uncertain histogenesis of these tumors. We report a case of a polypoid esophageal carcinosarcoma with a spontaneous resected stalk in a 45 year-old male patient who presented with progressive dysphagia and weight loss.
Carcinosarcoma* ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagus ; Humans ; Male ; Middle Aged ; Weight Loss

OBJECTIVE: To evaluate the clinical characteristics and perinatal outcomes in relation to the latency period after preterm premature rupture of membrane (PPROM). METHODS: We analyzed retrospectively the 223 pregnant women with PPROM who delivered before 34 weeks of gestation in Samsung Seoul Hospital from January 1996 to October 2003. The study population was divided into six groups according to the larency from membrane rupture and delivery (group I: shorter than 6 hours, group II: 6~48 hours, group III: 2~4 days, group IV: 4~7 days, group V: 7~12 days, group VI: beyond 12 days). RESULTS: The mean gestational age (GA) at rupture was 29.6+/-2.6 weeks and the mean GA at delivery was 30.6+/-2.4 weeks. The median latency was 102 hours and 67% of patients delivered within 7 days. The latency was prolonged with GA at rupture before 30 weeks and used of tocolytics. After adjustment of GA at delivery, pathologic chorioamnionitis occurred more frequently in group V than group I. Respiratory distress syndrome occurred less frequently in group II and group IV than group I. Neonatal mortality rate was highest in group I, but the other neonatal morbidities were not significant differences. CONCLUSION: In PPROM with delivery before 34 weeks, prolongation of the latency longer than 6 hours seems to be beneficial for reducing neonatal RDS and mortality, but infectious morbidity seems to increase when the latency was prolonged longer than 7 days without any benefits for perinatal outcomes.
Chorioamnionitis ; Female ; Gestational Age ; Humans ; Infant ; Infant Mortality ; Latency Period (Psychology)* ; Membranes* ; Mortality ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Rupture* ; Seoul ; Tocolytic Agents

OBJECTIVE: To study the differences in the pregnancy outcomes of severe preeclampsia before 32 weeks of gestation in relation to the latency between admission and delivery. METHODS: We reviewed medical records of 89 pregnant women who were managed in Samsung Medical Center because of severe preeclampsia before 32 weeks of gestation between January 1996 and February 2004. We studied the differences in the management and the neonatal outcomes between the immediate delivery group (admission to delivery < or =2 days) and the expectant management group (admission to delivery>2 days). We excluded maternal renal disease, chronic hypertension, multiple pregnancies, diabetes and placenta previa from this study. RESULTS: 40 women were included in the immediate delivery group and 49 women in the expectant management group. Antenatal corticosteroid was given pregnant women in the expectant management group (89.8% vs. 52.5%, p<0.0001). There was no significant difference in the occurrence of small for gestational age- and prematurity-related complications including neonatal mortality. There was significantly less respiratory distress syndrome in the expectant management group (46.9% vs. 62.5%, p=0.0315). However this difference disappeared when the adjustment was made to the gestational age at delivery (p=0.223). CONCLUSION: The latency period does not seem to alter the neonatal prognosis in severe preeclampsia before 32 weeks of gestation but the gestational age at the delivery, a reflection of the severity of the preeclampsia, seems to be the single most important factor for the occurrence of neonatal respiratory distress syndrome.
Female ; Gestational Age ; Humans ; Hypertension ; Infant ; Infant Mortality ; Latency Period (Psychology) ; Medical Records ; Placenta Previa ; Pre-Eclampsia* ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Multiple ; Pregnant Women ; Prognosis ; Renal Insufficiency, Chronic ; Respiratory Distress Syndrome, Newborn

Abdominal aortic aneurysm (AAA) is a chronic dilation of the aorta with a tendency to enlarge and eventually rupture, which constitutes a major cause of cardiovascular mortality.Although T-cell infiltrates have been observed in AAA, the cellular, phenotypic, and functional characteristics of these tissue-infiltrating T cells are not fully understood. Here, we investigated the proportional changes of T-cell subsets—including CD4 + T cells, CD8 + T cells, and γδ T cells—and their effector functions in AAAs. We found that Vδ2 + T cells were presented at a higher frequency in aortic aneurysmal tissue compared to normal aortic tissue and PBMCs from patients with AAA. In contrast, no differences were observed in the frequencies of CD4 + , CD8 + , and Vδ1 + T cells. Moreover, we observed that the Vδ2 +T cells from AAA tissue displayed immunophenotypes indicative of CCR5 + non-exhausted effector memory cells, with a decreased proportion of CD16 + cells. Finally, we found that these Vδ2 + T cells were the main source of IL-17A in abdominal aortic aneurysmal tissue. In conclusion, our results suggest that increased Vδ2 + T cells that robustly produce IL-17A in aortic aneurysmal tissue may contribute to AAA pathogenesis and progression.