BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

There are considerable in vitro and in vivo evidences for remineralization and demineralization occurring simultaneously in incipient enamel caries. In order to "heal"the incipient dental caries, many experiments have been carried out to determine the optimal conditions for remineralization. It was shown that remineralization is affected by different pH, lactic acid concentrations, chemical composition of the enamel, fluoride concentrations, etc. Eighty specimens from sound permanent teeth without demineralization or cracks, 0.15 mm in thickness, were immersed in lactic acid buffered demineralization solutions for 3 days. Dental caries with a surface zone and subsurface lesion were artificially produced. Groups of 10 specimens were immersed for 10 or 12 days in lactic acid buffered remineralization solutions consisting of pH 4.3 or pH 6.0, and 100, 50, 25, or 10 mM lactic acid. After demineralization and remineralization, images were taken by polarizing microscopy (x100) and micro-computed tomography. The results were obtained by observing images of the specimens and the density of the caries lesions was determined. 1. As the lactic acid concentration of the remineralization solutions with pH 4.3 was higher, the surface zone of the carious enamel increased and an isotropic zone of the subsurface lesion was found. However, the total decalcification depth increased at the same time. 2. In the remineralization solutions with pH 6.0, only the surface zone increased slightly but there was no significant change in the total decalcification depth and subsurface zone. In the lactic acid buffer solutions with the lower pH and higher lactic acid concentration, there were dynamic changes at the deep area of the dental carious lesion.
Dental Caries ; Dental Enamel ; Fluorides ; Hydrogen-Ion Concentration ; Lactic Acid ; Microscopy ; Tooth

Adenocarcinoma of small intestine is rare disease, but its incidence of iluem is the least of small intestinal adenocarcinoma. Its rarity and vague symptoms results in delayed diagnosis, treatment and poor prognosis, Recently we experienced a 65 years old man of ileal adenocarcinoma with liver metastasis, which does not obstuct intestinal lumen, We treat the metastatic tumor with chemoembolization(lipiodol and doxorubicin) through the hepatic artery and so we report the case with review of literature.
Adenocarcinoma ; Aged ; Delayed Diagnosis ; Hepatic Artery ; Humans ; Incidence ; Intestine, Small ; Liver ; Neoplasm Metastasis* ; Prognosis ; Rare Diseases

As part of an initial inquiry into the function of the outer membrane proteins (OMPs) of Helicobacter pylori Korean strain 51, we have conducted an extensive proteome analysis via quadrupole time of flight (Q-TOF) mass spectrometry (MS). Fifty one OMPs of H. pylori were purified using sarcosine and resolved via two-dimensional electrophoresis with immobilized pH gradient strips. The most abundant proteins were observed in the alkaline pI regions (6.0~11.0) at molecular masses between 10~100 KDa. Here, 15 spots were identified, representing 9 types of genes (KHP0852, KHP0853, KHP1353, KHP1017, KHP0172, KHP0076, KHP0617, KHP1069, KHP0614) from the sarcosin-insoluble fraction of H. pylori 51. These may be employed in the characterization of the OMPs of H. pylori 51, which will help to identify new potential target proteins for vaccine development and drug therapy.
Electrophoresis ; Helicobacter ; Helicobacter pylori ; Mass Spectrometry ; Membrane Proteins ; Membranes ; Proteins ; Proteome ; Proton-Motive Force ; Sarcosine ; Sprains and Strains

Malaria was rarely reported in patients with systemic lupus erythematosus (SLE). We report a case of P. vivax infection in a patient with SLE. A 42-year-old woman was admitted to the hospital because of fever, anemia, and severe thrombocytopenia and had transfusion of multiple blood products including 16 units of red blood cells (RBC). The patient was diagnosed as having SLE complicated with antiphospholipid syndrome. From the 96th hospital day, the patient had cyclic high fever for 4~5 hours, myalgia and shaking chills, follwed by generalized diaphoresis and resolution of fever. Examination of her peripheral blood smear showed gametocytes of P. vivax. She received hydroxychloroquine of a total dose of 25 mg/kg orally over 3 days and then oral primaquine 15 mg/day for 14 days. Blood donors were traced retrospectively. The 13 RBC products were negative for malaria but other three RBC products could not be checked on P. vivax. The patient was presumed to have acquired malaria from infected blood products. Relapse did not occur 1 year later. In conclusion, malaria should be considered in the differential diagnosis of persistent fever in a patients with SLE who received multiple blood products in Korea.
Adult ; Anemia ; Antiphospholipid Syndrome ; Blood Donors ; Chills ; Diagnosis, Differential ; Erythrocytes ; Female ; Fever ; Humans ; Hydroxychloroquine ; Korea ; Lupus Erythematosus, Systemic* ; Malaria ; Myalgia ; Plasmodium vivax* ; Plasmodium* ; Primaquine ; Recurrence ; Retrospective Studies ; Thrombocytopenia

PURPOSE: To evaluate between DHS and ITST nail (2nd generation) on the treatment of unstable femur intertrochanteric fracture in patients over 70 years old. MATERIALS AND METHODS: 61 cases of unstable intertrochanteric fracture (grouped 37 patients with DHS and 24 patients with ITST) who were taken the operation from Mar. 2003 to Sep. 2007 were analysed regarding to union time, sliding length of lag screws, operation time, blood loss, postoperative complications and functional recovery score by Skovron. RESULTS: The mean union time was 14.7 weeks in study group (ITST). The mean union time was 16.2 weeks in control group (DHS). The lag screw slidings were 7.2 mm in study group and 8.7 mm in control group. The operation times were 57.9 min in study group and 76.9 min in control group. The amount of blood loss were 67.7 ml in study group and 227.4 ml in control group. The complications were 4 cases in study group and 4 cases in control group. The Skovron recovery scores were 76.5% in study group and 73.7% in control group. CONCLUSION: From a practical point of short operation time, less amount of bleeding and less complication, author think that the ITST nail is useful implant for treatment of unstable femur intertrochanteric fracture in patient of old age.
Femur ; Hemorrhage ; Hip ; Humans ; Nails ; Postoperative Hemorrhage

PURPOSE: To determine the frequency of complications and diagnostic accuracy of CT-guided percutaneous automated gun biopsy, and to compare the results with those reported for fine needle aspiration. MATERIALS AND METHODS: Using automated biopsy devices, 118 CT-guided percutaneous biopsies of pulmonary lesions were performed. An 18-gauge needle was used. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 118 biopsies. RESULT: Four of 118(3.3%) patients developed pneumothorax and two of these required chest tube insertion. Other complications were resolved spontaneously. 106 biopsies (89.8%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and of benign disease, sensitivity was 91.8% and 87.7% respectively ; the corresponding figures for diagnostic accuracy were 88.5% and 78.9%. CONCLUSION: CT-guided automated gun biopsy of the pulmonary lesions is safe, witha pneumothorax rate comparable to that of fine needle aspiration. In the absence of a trained cytologist at the time of biopsy, the diagnostic accuracy of automated gun biopsy of pulmonary lesions compared favorably with the reported accuracy of fine needle aspiration.
Biopsy* ; Biopsy, Fine-Needle ; Chest Tubes ; Diagnosis ; Needles ; Pneumothorax ; Retrospective Studies

This study investigated the effect of intermittent polymerization on the rate of polymerization shrinkage and cuspal deflection in composite resins. The linear polymerization shrinkage of each composite was measured using the custom-made linometer along with the light shutter specially devised to block the light at the previously determined interval. Samples were divided into 4 groups by light curing method; Group 1) continuous light (60s with light on); Group 2) intermittent light (cycles of 3s with 2s light on & 1s with light off for 90s); Group 3) intermittent light (cycles of 2s with 1s light on & 1s with light off for 120s); Group 4) intermittent light (cycles of 3s with 1s light on & 2s with light off for 180s). The amount of linear polymerization shrinkage was measured and its maximum rate (Rmax) and peak time (PT) in the first 15 seconds were calculated. For the measurement of cuspal deflection of teeth, MOD cavities were prepared in 10 extracted maxillary premolars. Reduction in the intercuspal distance was measured by the custom-made cuspal deflection measuring machine. ANOVA analysis was used for the comparison of the light curing groups and t-test was used to determine significant difference between the composite resins. Pyramid showed the greater amount of polymerization shrinkage than Heliomolar (p < 0.05). There was no significant difference in the linear polymerization shrinkage among the groups. The Rmax was group 4 < 3, 2 < 1 in Heliomolar and group 3 < 4 < 2, 1 in Pyramid (p < 0.05). Pyramid demonstrated greater cuspal deflection than Heliomolar. The cuspal deflection in Heliomolar was group 4 < 3 < 2, 1 and group 4, 3 < 2, 1 in Pyramid (p < 0.05). It was concluded that the reduced rate of polymerization shrinkage by intermittent polymerization can help to decrease the cuspal deflection.
Acrylic Resins ; Bicuspid ; Composite Resins ; Light ; Polymerization ; Polymers ; Polyurethanes ; Tooth

The factors related to death and functional recovery after primary pontine hemorrhage (PPH) in Koreans has not been well defined. The authors sought to identify independent predictors of death and functional recovery after PPH using data obtained at a single institute. Data were collected retrospectively on 281 patients with PPH admitted to the Stroke Unit at our hospital between January 1, 2000 and December 31, 2009. Multivariate logistic regression analysis was used to evaluate the associations between selected variables and 30-day mortality and 90-day functional recovery after PPH. One-hundred and ten patients (39.1%) died within 30 days of PPH and 27 patients (9.6%) achieved functional recovery within 90 days. By multivariate analysis, unconsciousness, dilated pupils, abnormal respiration, systolic blood pressure < 100 mmHg, hydrocephalus, and conservative treatment were found to be predictors of 30-day mortality, whereas consciousness, intact motor function, no history of hypertension or diabetes mellitus, intact eye movement, a hematoma volume of < 5 mL, no ventricular hemorrhage, and normally sized ventricle were found to be predictors of 90-day functional recovery. The present findings suggest that systolic hypotension of less than 100 mmHg may predict 30-day mortality and a history of underlying hypertension and diabetes mellitus may predict 90-day functional recovery.
Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; *Brain Stem ; Diabetes Complications ; Female ; Humans ; Hydrocephalus/complications ; Hypertension/complications ; Intracranial Hemorrhages/complications/epidemiology/*mortality ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; *Recovery of Function ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Time Factors ; Unconsciousness/complications