No abstract available.
Mandible*

Hemodialysis that to maintain life quality and may be preliminary stage of kidney transplantation is essential in end-stage renal disease(Esrd) patients. Since 1996, Brescia-cimino are used to internal radio- cephalic fistula and this fistula method was the most popular in world-wide. And then variable methods (e.g, Autogenous, PTFE, Dacron etc.) were usually tried instead of above standard fistula. We experienced 75 fistulas in 62 cases from Jan. 1993 to Dec. 1996 and among 75 fistula operations standard radio-cephalic fistula was 56, brachio-cephalic fistula 10, graft fistula 9. Early patency failure rate of A-V fistula was 9 cases, 14.5%. Significant factors to effect in patency of A-V fistula were propably diabetic mellitus, venous diameter, graft material and were not related to age/sex, blood pressure, BUN/creatinine etc. In conclusion the reduction of early patency failure rate in A-V fistula is to maintain long patency rate of A-V fistula
Blood Pressure ; Fistula ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Quality of Life ; Renal Dialysis ; Transplants

Spontaneous spinal subdural hematoma (SDH) is very rare. Furthermore, intracranial vasospasm (ICVS) associated with spinal hemorrhage has been very rarely reported. We present an ICVS case without intracranial hemorrhage following SDH. A 41-year-old woman was admitted to our hospital with a complaint of severe headache. Multiple intracranial vasospasms were noted on a brain CT angiogram and transfemoral cerebral angiography. However, intracranial hemorrhage was not revealed by brain MRI or CT. On day 3 after admission, weakness of both legs and urinary incontinence developed. Spine MRI showed C7~T6 spinal cord compression due to hyperacute stage of SDH. After hematoma evacuation, her symptoms gradually improved. We suggest that spinal cord evaluation should be considered in patients with headache who have ICVS, although intracranial hemorrhage would not be visible in brain images.
Adult ; Brain ; Cerebral Angiography ; Female ; Headache ; Hematoma ; Hematoma, Subdural, Spinal* ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Leg ; Magnetic Resonance Imaging ; Spinal Cord ; Spinal Cord Compression ; Spine ; Subarachnoid Hemorrhage ; Urinary Incontinence ; Vasospasm, Intracranial*

Functional brain imaging is very important in the diagnosis and evaluation of the various neurologic disorders, In addition to electroencephalography (EEG) and positron emission tomography(PET), single photon emission computed tomography (SPECT)have increasingly gained importance in determination of disturbancesin regional brain functions. Both ictal and interictal Tc-99m hexamethy-propyleneamine oxime single photon emission computed tomography (TC-99m HMPAO SPECT)was done in a patient with the neonatal seizure and right cerebral hemiatrophy. The left parieto-occipital area revealed increased redioactivity during ictal stage and decreased radioactivities during interictal stage on Tc-99m HMPAO Brain SPECT. This brain ares was thought to be a epileptogenic focus. Ictal and interictal Tc-99m HMPAO brain SPECT could be a safe and sensitive diagnostic method in localization of epileptogenic foci.
Brain* ; Diagnosis ; Electroencephalography ; Electrons ; Functional Neuroimaging ; Humans ; Nervous System Diseases ; Radioactivity ; Seizures* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To assess the changes in mean corneal refractive power (DeltaK) following pterygium surgery and to predict DeltaK in cases of combined cataract and pterygium surgery. METHODS: Thirty-seven eyes of unilateral pterygium patients who underwent pterygium surgery were analyzed retrospectively with at least more than 1 month of follow-up. Preoperative and postoperative 1 month corneal refractive power was measured using auto-keratometer (RK-F1, Canon, Tokyo, Japan). Pterygium horizontal extension, width, and area were measured and correlation with DeltaK before and after surgery analyzed. We also compared DeltaK of the contralateral normal eye. RESULTS: The mean corneal refractive (Km) power measured before and 1 month after surgery was 43.30 +/- 1.66 D and 44.07 +/- 1.42 D, respectively. The Km significantly increased at 4 weeks after surgery (p < 0.001). However, postoperative Km was not significantly different when compared with the contralateral normal eye (43.86 +/- 1.34 D; p = 0.59). All parameters of pterygium size including horizontal extension, width, and area were positively correlated with the mean DeltaK. Among parameters, horizontal extension was best correlated with mean DeltaK (p < 0.001). The mean DeltaK with horizontal extension was predicted using linear regression (2.5 mm to 1 D, 4.0 mm to 1.8 D). CONCLUSIONS: We recommend contralateral corneal refractive power or prediction of corneal refractive power using linear regression with pterygium horizontal extension for determining intraocular lens power in cases of combined cataract and pterygium surgery.
Cataract ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Linear Models ; Pterygium* ; Retrospective Studies

No abstract available.
Hypopituitarism*

PURPOSE: To assess the diagnostic efficacy of magnetic resonance (MR) imaging in the detection of a vertebralartery injury occurring from major cervical spine trauma. MATERIALS AND METHODS: Conventional MR findings of 63patients and 63 control subjects were compared to detect a possible change in the vertebral arteries resulted fromtrauma. Plain films, CT and clinical records were also reviewed to correlate the degree of cervical spine injurywith vascular change. RESULTS: Nine cases of absent flow signals in vessel lumen were observed in eight patientsand one was observed in the control group. Patients more frequently demonstrated other abnormalities such asintraluminal linear signals (n=3) or focal luminal narrowing (n=9) but there was no statistical significance. There was a close relationship between degree of cord damage and occlusion of the vertebral artery. CONCLUSION: Conventional MR imaging is useful in the detection of vertebral artery occlusion resulting from cervical spinetrauma.
Humans ; Magnetic Resonance Imaging ; Phenobarbital ; Spine* ; Vertebral Artery*

PURPOSE: Endovascular therapy (ET) for peripheral arterial occlusive disease has increased dramatically in the past decade. ET is currently being performed by different specialists with available resources, with some of these resources being far superior to others, yet there have been no studies comparing the interventional outcomes according to the varying resources. The aim of this study was to analyze the outcomes of ET for superficial femoral artery (SFA) atherosclerosis using a mobile C-arm, in comparison to a historical control group. METHODS: Between March 2009 and December 2010, ET for SFA atherosclerosis was performed in 54 limbs from 47 patients using a mobile C-arm in the operation theater (mobile group). In contrast, a historical group for comparison consisted of 60 patients, for whom ET for SFA atherosclerosis was performed in 76 limbs using a fixed C-arm in the angiographic suite, between July 2003 and May 2008 (fixed group). The outcomes of ET for both groups were retrospectively analyzed by a medical chart review. RESULTS: There was no statistically significant difference in gender, age, risk factors, Trans-Atlantic Inter-Society Consensus (TASC) classification, intervention type, and postoperative blood creatinine levels between the two groups. However, procedural time was statistically higher in the mobile group. Patency rates at 1 year were 68.3% and 68.1% in the fixed and mobile group, respectively, which was not statistically significant. Subgroup analysis of 1 year patency rates for TASC A, B lesions and TASC C, D lesions were also similar. CONCLUSION: ET using the mobile C-arm in the operating theater is as effective as using the fixed C-arm, in the treatment of SFA atherosclerosis in terms of the technical success, patency, and early postoperative outcomes.
Arterial Occlusive Diseases ; Atherosclerosis ; Consensus ; Creatinine ; Endovascular Procedures ; Extremities ; Femoral Artery ; Humans ; Peripheral Arterial Disease ; Retrospective Studies ; Risk Factors ; Specialization

The study was designed to investigate the effect of serum glucose, insulin and insulin resistance on the risk of prostate cancer (CaP) and on the clinicopathological characteristics in Korean men. Subjects were retrospectively recruited from 166 CaP patients underwent radical prostatectomy and 166 age-matched benign prostatic hyperplasia (BPH) patients. The serum was taken on the morning of the day of operation and insulin resistance was assessed by homeostasis model assessment insulin resistance index (HOMA-IR). Men in highest tertile of insulin was associated with 55% reduced odds of CaP than those with the lowest tertile (OR = 0.45, 95% CI = 0.23-0.89, P = 0.022). The patients in highest tertile of insulin had a more than 5.6 fold risk of locally advanced stage than those in the lowest tertile (OR = 5.62, 95% CI = 1.88-16.83, P = 0.002). Moreover, the patients in the highest tertile HOMA-IR group was associated with an increased risk of locally advanced stage than the lowest tertile group (OR = 3.10, 95% CI = 1.07-8.99, P = 0.037). These results suggest that elevated insulin and insulin resistance are associated with the advanced pathological stage of prostate cancer in Korean patients.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis ; Humans ; Insulin/*blood ; *Insulin Resistance ; Male ; Middle Aged ; Neoplasm Grading ; Odds Ratio ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/etiology/*pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors

PURPOSE: To compare the results of the thoracoscopic approach and open thoracotomy retrospectively for scoliosis requiring anterior release and fusion followed by posterior correction. MATERIALS AND METHODS: Of 22 rigid scoliosis patients, 10 open thoracotomy cases (group I) were compared with 12 thoracoscopic cases (group II) in terms of blood loss, operation time, and chest pain (visual analogue scale, VAS), as checked 1 week after operation and final follow-up, correction ratio of major curve and complications. Posterior correction was performed 2 weeks after anterior release. Statistical analysis of group differences was performed using the t-test or the Mann-Whitney. RESULTS: Blood loss was higher in group I, 268.0 mL (200-530) than in group II, 195.0 mL (100-280) (p=0.047). The operation time was shorter in group I, 108.0 minutes (90-180) than in group II, 175.0 minutes (120-240) (p=0.001), and chest pain (visual analogue scale, VAS) which was checked at 1 week after operation and at final follow-up was milder in group II, 3.9 (3-6), 1.6 (0-3) than in group I, 5.8 (4-8), 3.1 (1-5) (p=0.005, p=0.013, respectively). The correction ratios of the major curve between two groups were similar. The cosmetic aspects of the thoracoscopic approach were favorable. The postoperative complications were 1 pneumothorax in each group and 3 chronic chest pain in group I. CONCLUSIONS: The results of thoracoscopic approach for anterior release were compared favorably with standard open thoracotomy in terms of blood loss, chest pain both postoperatively and at final follow-up, and cosmetics, but unfavorably for operation time.
Chest Pain ; Follow-Up Studies ; Humans ; Pneumothorax ; Postoperative Complications ; Retrospective Studies ; Scoliosis* ; Thoracoscopy ; Thoracotomy*