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

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

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

We experienced a case of a tracheoesophageal cyst in the posterior mediastinum of a three-year-old girl, who complained of cough and fever. We confirmed this case by computerized tomography and pathologic examination after surgical resection. A brief review of the literature is presented.
Case Report ; Child, Preschool ; Cysts/*pathology/radiography/surgery ; Esophageal Cyst/*pathology/radiography/surgery ; Female ; Human ; Mediastinal Diseases/*pathology/radiography ; Trachea/*pathology/radiography/surgery

We experienced a case of a tracheoesophageal cyst in the posterior mediastinum of a three-year-old girl, who complained of cough and fever. We confirmed this case by computerized tomography and pathologic examination after surgical resection. A brief review of the literature is presented.
Case Report ; Child, Preschool ; Cysts/*pathology/radiography/surgery ; Esophageal Cyst/*pathology/radiography/surgery ; Female ; Human ; Mediastinal Diseases/*pathology/radiography ; Trachea/*pathology/radiography/surgery

BACKGROUND AND OBJECTIVES: Combination of ticlopidine and aspirin has been accepted as a standard antiplatelet regimen after coronary stenting because it reduced the rate of cardiac events and hemorrhagic-vascular compli-cations compared with intensive anticoagulation. Ticlopidine use, however, may accompany serious side effects such as neutropenia or liver dysfunction. Cilostazol, a c-AMP phosphodiesterase inhibitor, is a novel antiplatelet agent which is known to have less side effects. MATERIALS AND METHODS: We compared the efficacy and safety of ci lostazol plus aspirin (CA) with ticlopidine plus asprin (TA) after elective coronary stenting. Patients were randomly assigned to receive either CA or TA two days before stenting. The primary end point was a composite of angiographic stent thrombosis, death, myocardial infarction (Q or Non-Q), repeat intervention or bypass su rgery at 30 days. The secondary end points were hemorrhagic-vascular complications, or drug side effects such as neutropenia, thrombocytopenia, or any side effects requiring cessation of drugs at 30 days. RESULTS: After randomization of 300 patients equally to each group, 4 patients were excluded from the analysis: 1 failure of stenting, 3 follow-up loss. The primary end point was reached in 2 patients (1.4% ) in CA group and 3 patients (2.0% ) in TA group (p=1.0). The rate of hemorrhagic-vascular complications was not different between the gr oups (1.4% vs 2.0%, p=1.0). The incidence of significant drug-related side effects was not statistically different between CA group and TA group (0.7% vs 2.7%, p=0.37). However, serious side effect such as neutropenia was seen only in TA group. CONCLUSION: Compared with TA, CA has comparable effect for the prevention of stent thrombosis and major cardiac events with similar rate of hemorrhagic-complications and drug-related side effects after elective coronary-artery stenting. Thus CA regimen can be a safe alternative to TA in elective implantation of coronary artery stent.
Aspirin ; Coronary Vessels ; Follow-Up Studies ; Humans ; Incidence ; Liver Diseases ; Myocardial Infarction ; Neutropenia ; Random Allocation ; Stents ; Thrombocytopenia ; Thrombosis ; Ticlopidine*