No abstract available.

PURPOSE: Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center. MATERIALS AND METHODS: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified. RESULTS: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5+/-14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3+/-21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012). CONCLUSION: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
Arm* ; Arteriovenous Fistula ; Catheterization ; Central Venous Catheters ; Diabetes Mellitus ; Dialysis* ; Fistula ; Humans ; Male ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Transplants

Reiters syndrome is an unusual disease characterized a triad of nongonococcal urethritis, conjunctivitis, and arthritis in association with the mircoutaneous lesions of keratoderma blenorrhagica and balarintis circinata. We present herein a case of Reiters syndome combined yiti lung cancer. A 39-year-old man has experienced naigrating polyarthralgia and high fever ilitermittently for about 20 years, Hyperkeratotic erythemnous patches and plaques, which dyeliped about 1 year ago, have aggravated and expanded to the whole body. Histopathologic sections from the plaque on the right forc ari showed characteristic findings including thickened parakeratotic horny layer and spongiform micropustules of Kogoji He was associated with HLA-B27. On the chest X-ray, a thumbtip size mass was incidently found. Chest CT and bone scan findings supported lung cancer and multiele metastases.
Adult ; Arthralgia ; Arthritis ; Conjunctivitis ; Fever ; HLA-B27 Antigen ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Thorax ; Tomography, X-Ray Computed ; Urethritis

PURPOSE: The purpose of this study was to develop in vivo dosimetries using both chromosomal aberrations and micronuclei in mice to assess biological effects of radiations. MATERIALS AND METHODS: Five each mice were irradiated with 0, 1, 2, 3, 4, 5, 10 Gy of Cs-137 gamma-rays. We scored numbers of chromosomal aberrations in metaphase spreads and numbers of micronuclei in bone marrow smears under light microscope, and obtained the dose-response relationships. We also examined the relationship between the two dose-response curves. RESULTS: The frequency of both chromosomal aberrations and micronuclei increased with dose, in a linear-quadratic manner. The delta, beta, and alpha coefficients were 0.0176, 0.0324, and 0.0567 for metaphase analysis (r=1.0, p<0.001) and 0.0019, 0.0073, and 0.0506 for micronuclei assay (r=1.0, p<0.001). The frequency of chromosomal aberrations and micronuclei in diffirent radiation doses was significantly correlated (r=0.99, p<0.01). CONCLUSION: In vivo dosimetry using either metaphase analysis or micronucleus assay was feasible in mice. These methods could be useful to evaluate biological effects of radiation.
Animals ; Bone Marrow Cells* ; Bone Marrow* ; Chromosome Aberrations ; Metaphase* ; Mice* ; Micronucleus Tests

We successfully closed the isolated patent ductusarteriosus(PDA) in 2 female patients using the Rashkind Double-Disc Occlusion system. nonsurgical closure of PDA usin plug was introduced by Porstmann in 1968 through transfemoral artery catheter and using umbrella by Rashkind in 1977 througth venous site. There has been continued improvement and simplification of the equipment as well as in the implantation technique. Nowaday, a multicenter study was conducted to test the safety and effectiveness of this interventioal method in States. Successful closure rate was high but some problems were reported such as embolization, abnormal deployment and residual shunt. Residual shunt was visualized by aortography in our both cases immediately after intervention but continuous murmur could not be heard in both cases. Oxygen step-up disappeared immediately after occluder implantation in both cases. Complete occlusion was expected with thrombus in near future.
Aortography ; Arteries ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Humans ; Oxygen ; Thrombosis

PURPOSE: To assess the efficacy and safety of a IRIS(innovative replacement of incontinence surgery) procedure for surgical treatment of stress urinary incontinence in women during the follow-up of 2 years. MATERIALS AND METHODS: From March 2003 to March 2004, 48 women with stress urinary incontinence underwent a IRIS procedure under local, spinal or general anesthesia. Post-operative evaluation was carried out after 1 month, 12 months and 24 months. The mean age was 51.1+/-11.0 years and mean follow-up period was 32.1+/-3.8 months. Operation time, success rate and patient's satisfaction, perioperative and postoperative complications were evaluated. RESULTS: The mean operation time was 24.46+/-1.95 minutes and mean hospital stay was 1.77+/-0.75 days. The success rates were 95.8%(cured 79.2%, improved 16.7%) and 93.8%(cured 75.0%, improved 18.8%), at the 1 and 2-year follow-up, respectively. The satisfaction rates were 91.7% at 1-year follow-up and persisted at 2-year follow-up. There were no serious or long-term complications related to the procedure, and no significant changes in the postoperative outcome over time. CONCLUSION: Our results demonstrate that the IRIS procedure is as safe and effective as TVT procedure for the treatment of female stress urinary incontinence, although longer follow-up is necessary to determine long-term effect.
Anesthesia, General ; Female* ; Follow-Up Studies* ; Humans ; Iris* ; Length of Stay ; Postoperative Complications ; Urinary Incontinence*

PURPOSE: We evaluated the efficacy and safety of the tension-free vaginal tape(TVT) procedure for the treatment of female stress urinary incontinence over a 6-year period. MATERIALS AND METHODS: We reviewed retrospectively our experience with 63 patients who underwent a TVT procedure for stress urinary incontinence, between March 1999 and March 2000. The preoperative evaluations included a comprehensive medical history, physical examination, urinalysis, urine culture, one hour pad test, urodynamic study including valsalva leak point pressure(VLPP) and maximal urethral closing pressure(MUCP). Long-term evaluations were performed by questionnaires on the durability of surgical outcome and the patients' satisfaction of the procedure. RESULTS: The TVT procedure remained successful in 95.2%(cured 81.0%, improved 14.3%) and 93.7%(cured 77.8%, improved 15.9%) at the 1 and 6-year follow-up, respectively. The satisfaction rates were 93.7% and 92.1%, at the 1 and 6-year follow-up, respectively. There were no serious or long-term complications related to the procedure. CONCLUSION: The TVT procedure seems to be a minimally invasive, safe and effective surgical procedure for the treatment of female stress urinary incontinence, with long-term durability of continence and minimal complications related to the surgery.
Female* ; Follow-Up Studies ; Humans ; Physical Examination ; Surveys and Questionnaires ; Retrospective Studies ; Suburethral Slings* ; Urinalysis ; Urinary Incontinence* ; Urodynamics

Paraquat is the most important bipyridyl herbicide, acting as a norselective herbicide with somewhat unique properties. The major acute local cutaneous side effects reslt from the caustic properties of paraquat, which produce local ulceration of the epithelial surface. Blistering of the skin and cracking and even loss of the fingernails have been reported. Its systemic taxic ties also include pulmonary fibrosis, cardiac failure, renal failure, and hepatotoxicity. We report a case of erytlema multiforme with transient heat-toxicity due to percutanious absorption of paraquat. A 31-year-old farmer was admitted to our de artment because of target-like bullous erythema on both thighs and buttocks following accidenta contact with paraquat. The histopathologic findings show d spongiesis, exocytosis, intercellular dema in the epidermis, degeneration of dermo-epidermal junction and inflammatory cell infiltrations in the dermis especially papillary and perivascular area.
2,2'-Dipyridyl ; Absorption ; Adult ; Blister ; Buttocks ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Heart Failure ; Humans ; Nails ; Paraquat ; Pulmonary Fibrosis ; Renal Insufficiency ; Skin ; Thigh ; Ulcer

Blue rubber bleb nevus syndrome is a rare disease of cutaneous hemangioma of a variant of the carvenous type which is clinically characterized by multiple, protuberant, dark blue, generally soft, rubbery, and compressible cutaneous masses usually associated with similar lesions of the gastrointestinal tract. Most cases are sporadic, although autosomal dominant inheritance has been described. We report herein a cases of blue rubber bleb nevus syndrome in a 49-year-old, who had multiple, dark blue, slightly tender, easily compressible vascular tumors on the face, right postauricular area, tongue, neck, and right had and foot, measuring from 0.5 to 1.0 cm in diameter. Endoscopic examination also revealed several similar lesions on the upper third of the esophagus. Biopsy specimen from the lesion of the neck showed irregularly dilated vessels containing red blood cells and fibrinous material. The vascular space was lined by a single layer of flattened endothelial cells.
Biopsy ; Blister* ; Endothelial Cells ; Erythrocytes ; Esophagus ; Fibrin ; Foot ; Gastrointestinal Tract ; Hemangioma ; Humans ; Middle Aged ; Neck ; Nevus* ; Rare Diseases ; Rubber* ; Tongue ; Wills

OBJECTIVE: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. METHODS: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. RESULTS: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). CONCLUSION: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.
Amniotic Fluid ; Animals ; Anti-Bacterial Agents ; Female ; Fetal Blood ; Fetal Death ; Fetal Weight ; Fetus ; Hysteroscopy ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome ; Rabbits ; Sepsis