Removal of leukocytes from blood components may prevent alloimmunization to leukocyte antigens, febrile nonhemolytic transfusion reactions, transmission of leukotropic viruses or bacteria, and graft-versus-host disease. New surface-modified fibrous polyester filters were evaluated; they require no special processing of blood components and can be used at the patient's bed-side. Pall RC100TM(Pall Co., USA) was used to filter 2 units of RBCs at a time for a total of 8 filtrations: mean red cell recovery rate was 88.7%, mean WBC removal rate 99. 99%, and mean residual WBC count after filtration 2.77x 10 5. Twelve units of apheresis platelets were filtered with Pall PL50TM(Pall Co., USA): mean platelet recovery rate was 90.7%, mean WBC removal rate 99.95%, and mean residual WBC count after filtration 6.99 x 10 5. This study indicates that these filters efficiently remove WBCs without significant loss of red cells or platelets and that this kind of filters can be easily used at the patient's bed side.
Bacteria ; Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets ; Filtration ; Graft vs Host Disease ; HLA Antigens ; Leukocytes* ; Polyesters

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

Although the carotid endarterectomy presently represents the standard therapeutic approach for most patients with significant carotid artery stenosis, a percutaneous transluminal angioplasty (PTA) with stenting has become an alternative method for treating patients with co-mobid conditions, particulary coronary artery disease. A PTA with stenting has the potential for being safer, less traumatic, more cost-effective, and useful in patients at high surgical risk. As well, they are not limited to the cervical carotid artery. But it is reported that carotid angioplasty by femoral approach is difficult to do in 1 - 2% of patients with carotid stenosis due to abnormal origin of carotid artery or occlusion of femoral arteries. We succeeded in PTA with stenting of tight stenosis of right internal carotid artery through the transseptal approach in case of a sharply angled right brachiocephalic artery take-off from the aorta. The transseptal approach can be used for PTA with stenting in case of problems with femoral approach.
Angioplasty ; Aorta ; Arteries ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Disease ; Endarterectomy, Carotid ; Femoral Artery ; Humans ; Stents*

Takayasu's arteritis is a chronic inflammatory disease of unknown etiology involving the aorta, major branches of aorta, and pulmonary arteries and leads either stenosis and occlusion of the involved artery or aneurysm formation or both. The clinical course and prognosis are variable according to two major prognostic factors, ie, complications and the pattern of the past clinical course, as well as by ESR. Though the aggressive medical and surgical treatment are required for patients with a major complication and a progressive course, surgical reconstruction entails a high incidence of suture line complications including stenosis or dilatation. Moreover all the vascular lesions are amenable for vascular surgery. Initial reports revealed excellent results of percutaneous transluminal angioplasty (PTA) in patients with Takayasu's arteritis. However the suboptimal results and restenosis have been the main limitations of the PTA. Stenting has some benefits for early elastic recoil of the fibrotic vessels and restenosis as in other large vessels in Takayasu's arteritis or atherosclerosis. We report early and long-term results of two cases of carotid stenting in patients with symptomatic carotid stenosis and Takayasu's arteritis, which revealed variable angiographic results according to clinical courses and recommend that stenting in Takayasu's arteritis may be another treatment modality in inactive Takayasu's arteritis.
Aneurysm ; Angioplasty ; Aorta ; Arteries ; Atherosclerosis ; Carotid Arteries* ; Carotid Stenosis ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies* ; Humans ; Incidence ; Prognosis ; Pulmonary Artery ; Stents* ; Sutures ; Takayasu Arteritis

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

BACKGROUND AND OBJECTIVES: For patients with bilateral carotid artery stenosis, simultaneous bilateral carotid endarterectomy is rarely performed due to a higher perioperative risk for death and strokes. We assessed the immediate and long-term outcomes of simultaneous bilateral carotid stenting (SBCS) for internal carotid stenosis in patients at high surgical risk. MATERIALS AND METHODS: We analyzed 10 patients who underwent SBCS for de novo stenoses of both internal carotid arteries (ICA). Included were those who had 60% to 99% stenosis of extracranial ICAs irrespective of neurologic symptoms and had more than 2 risk factors of Mayo grade III (medical risks) or IV (neurologic risks). RESULTS: The patients had a mean age of 67+/-7 years. Technical success was achieved in all lesions. The mean percent diameter stenosis was reduced from 79+/-13% to 8+/-8%. A total of 21 Wallstents were deployed at 20 lesions. One patient had a minor stroke just after the procedure which was completely resolved with local injection of urokinase. There were no deaths, major strokes or myocardial infarctions during the 30 day follow-up. Six months imaging studies were available on all 9 eligible patients with 18 lesions by duplex sonography and angiography. Late clinical follow-up at a mean of 15.1+/-8.1 months revealed no occurrence of neurologic event or death. CONCLUSION: SBCS is feasible, safe and effective to treat bilateral de novo ICA stenoses in patients at high surgical risk. The procedure, however, is investigational and more experience is required to define its role in the treatment of this patient population.
Angiography ; Carotid Artery, Internal* ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Neurologic Manifestations ; Risk Factors ; Stents* ; Stroke ; Urokinase-Type Plasminogen Activator

Thirty percutaneous liver biopsy and one liver necropsy were reviewed in Severance Hospital, Yonsei University from June 1979 to September 1980. This procedure is the safe and accurate means of diagnosing and studying liver diseases in the pediatric patients especially persistent conjugated hyperbilirubinemia, chronic liver disease, and some rare diseases (eg. Histiocytosis-X, Storage disease disease, Gilbert syndrome), The significance of the technique and following results were obtained. 1. Among 31 cases, 14 cases were under 1 year of age 21 cases were male. 2. Evaluation of persistent neonatal conjugated hyperbilirubinemia, chronic hepatitis, Gaucher's disease, gilbert syndrome, congenital hepatic fibrosis, portal hypertension, and Histiocytosis-X were possible by the pathologic findings of percutaneous liver biopsy speciments. 3. Pathologic findings of 10 cases of neonatal conjugated hyperbilirubinemia are Giant cell hepatitis (4), acute hepatitis (1), acute fulminant hepatitis (1), extrahepatic biliary atresia (2), intra hepatic biliary hypoplasia (2), and hepatic fibrosis (1), Causative agents are hepatitis virus B (4), toxoplasma gondii (2), herpes simplex (1), syphilis (1), unknown (2). 4. One case of acute fullminent hepatitis due to herpes simplex was confirmed by electronmicroscopic study of the specimen. 5. One case of tuberculous empyema of the liver was confirmed by the discovery of tuberculi bacilus on the direct smear of the biopsy speciments, although the pathologic findings showed non specific findings of reactive hepatitis. 6. There was nonspecific information in systemic disease and hepatomegaly with fever of unko\nown origine. 7. There was no complication in 30 cases of percutaneous liver biopsy.
Biliary Atresia ; Biopsy* ; Empyema, Tuberculous ; Fever ; Fibrosis ; Gaucher Disease ; Giant Cells ; Gilbert Disease ; Hepatitis ; Hepatitis Viruses ; Hepatitis, Chronic ; Hepatomegaly ; Herpes Simplex ; Histiocytosis, Langerhans-Cell ; Humans ; Hyperbilirubinemia ; Hypertension, Portal ; Liver Diseases ; Liver* ; Male ; Needles* ; Rare Diseases ; Syphilis ; Toxoplasma

No abstract available.
Chloroquine* ; Edetic Acid* ; Glycine* ; Immunoglobulin G*