No abstract available.
Lung Neoplasms* ; Lung*

No abstract available.
Coronary Vessels* ; Fistula*

PURPOSE: The main cause of recurrence of varicosity after endovenous laser treatment (EVLT) is incomplete occlusion of the sapheno-femoral junction (SFJ) or the sapheno-popliteal junction (SPJ). To reduce the recurrence and complications of EVLT, we have tried to ligate the SFJ or SPJ under ultrasonic guidance. METHOD: Two separate parallel punctures were made under ultrasonic guidance 1 cm inferior to and alongside the SFJ or SPJ with using a 16 gauge needle. A hook was passed through beneath the saphenous vein and it was pulled out through the puncture holes. A black silk thread was passed through backward with the hook and then the thread was tied. Low energy EVLT was then performed in a continuous fashion with using a 980 nm multidiode laser. RESULT: Between December, 2007 and February, 2008, 21 patients (males: 14, females: 7, 28 legs, mean age: 45 years old) with including 20 great saphenous veins (GSV) and 8 small saphenous veins (SSV) were managed using our protocol. The mean energy density (ED) was 9.8J/cm for the GSV and 9.5J/cm for the SSV. The pullback speed on the fiber was 69.5 sec at the GSV and 28sec at the SSV. No recurrence was noted. The complications were bruise (7 limbs/24%), fibrotic cord (4 limbs/14%), pain (8 limbs/31%), inguinal pain and paresthesia (1 limb/3%) and hematoma (4 limbs/14%). These complications were well controlled without any further problems. CONCLUSION: During EVLT, ultrasound (US) guided ligation of the SFJ is cosmetically satisfactory and effective in reducing the amount of required endovenous laser energy. The complication rate and severity were not reduced, but they under control.
Contusions ; Hematoma ; Humans ; Leg ; Ligation ; Needles ; Paresthesia ; Punctures ; Recurrence ; Saphenous Vein ; Silk ; Ultrasonics ; Varicose Veins

No abstract available.
Adolescent* ; Arteries* ; Humans ; Male*

OBJECTIVE: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. METHODS: we performed reprospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propandiol (PROH) as a cryoprotectant. RESULTS: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7&% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. CONCLUSION: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.
Embryo Transfer* ; Embryonic Structures* ; Freezing ; Humans ; Infertility ; Insemination ; Male ; Pregnancy Rate* ; Pregnancy* ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Survival Rate ; Zygote

BACKGROUND: With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. MATERIAL AND METHOD: From March 2001 to March 2003 at the department of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, postoperative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. RESULT: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardiopulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p<0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p<0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). CONCLUSION: Contamination of patients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.
Blood Transfusion ; Cardiopulmonary Bypass ; Causality ; Diabetes Mellitus ; Emergencies ; Hemorrhage ; Humans ; Intensive Care Units ; Mediastinitis* ; Obesity ; Postoperative Hemorrhage ; Pulmonary Disease, Chronic Obstructive ; Reoperation ; Respiration, Artificial ; Retrospective Studies ; Risk Factors* ; Schools, Medical ; Sternotomy ; Surgical Procedures, Elective ; Thorax ; Wound Infection* ; Wounds and Injuries*

OBJECTIVE: To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. METHODS: We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support. RESULTS: Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women. CONCLUSION: Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.
Adult ; Aged ; Aging ; C-Reactive Protein ; Depression ; Female ; Friends ; Humans ; Inflammation ; Male ; Rural Population ; Spouses

The acknowledgements was incorrect in the original publication of this article.

Extracorporeal life support (ECLS) has well demonstrated its efficacy in treating in-hospital cardiac arrest and is being used for broader indications. However, ECLS after prolonged cardiopulmonary resuscitation (CPR) has been traditionally contraindicated and is now challenging. Here, we introduce two cases of successful ECLS after prolonged CPR, resulting in a immediate and full recovery. Both these acute ST elevation myocardial infarction patients waiting for primary percutaneous coronary intervention (PCI) suddenly collapsed due to ventricular fibrillation (VF), which was refractory to conventional treatment. After 2 hours of conventional CPR, the ECLS had been implemented and primary PCI could be performed. Subsequent to successful revascularization, the VF was stopped with a single electric shock. In our second case, normal sinus rhythm was spontaneously restored after ECLS implementation, which was completed after 45 minutes of conventional resuscitation. Both patients made a full neurological recovery on the day of the event and were discharged with only minor complications.
Cardiopulmonary Resuscitation ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Resuscitation ; Shock ; Ventricular Fibrillation

BACKGROUND: In the majority of cases, sternal instability and wound infection concomitantly present after a cardiac operation following conventional median sternotomy, and these complications have a major influence on the postoperative course. The aim of this study is to compare the results of the different sternal wiring techniques on sternal infection. MATERIAL AND METHOD: Between April 2004 and December 2008, 157 adult patients underwent cardiac operation through a median sternotomy. 86 patients who had undergone standard peristernal wiring were included in group A, whereas 71 patients who had undergone modified Robicsek sternal wiring were included in group B. The incidences of sternal wound complications in the two groups were assessed. RESULT: The mean age of the group B patients was older than that of the group A patients (61+/-10 years vs 57+/-13 years). The incidence of preoperative left ventricular dysfunction (ejection fraction <30%), chronic obstructive pulmonary disease, renal failure requiring dialysis and diabetes mellitus were significantly higher in Group B, whereas the other perioperative risk factors for infection were not significantly different between the two groups. Two patients in group A experienced superficial wound infection, whereas 4 patients in group B displayed superficial wound infection, but the difference was not statistically significant (p=0.255). Yet poststernotomy deep sternal wound infection appeared in 6 patients of group A, whereas none of the patients in group B displayed this malady. CONCLUSION: The modified Robicsek sternal wiring technique showed greater sternal stability even for the patient with a high risk for infection, and the technique caused a lower incidence of deep sternal wound infection.
Adult ; Diabetes Mellitus ; Dialysis ; Humans ; Incidence ; Pulmonary Disease, Chronic Obstructive ; Renal Insufficiency ; Risk Factors ; Sternotomy ; Sternum ; Ventricular Dysfunction, Left ; Wound Infection