Regular exercise training increases the number of endothelial progenitor cells and decreases homocysteine levels in healthy peripheral blood.

Endothelial progenitor cells (EPCs) are known to play an important role in the repair of damaged blood vessels. We used an endothelial progenitor cell colony-forming assay (EPC-CFA) to determine whether EPC numbers could be increased in healthy individuals through regular exercise training. The number of functional EPCs obtained from human peripheral blood-derived AC133 stem cells was measured after a 28-day regular exercise training program.

Negative pressure wound therapy for inguinal lymphatic complications in critically ill patients.

Purpose: In this study, we investigated the therapeutic potential of regulated negative pressure vacuum-assisted wound therapy for inguinal lymphatic complications in critically ill, liver transplant recipients.

Methods: The great saphenous vein was harvested for hepatic vein reconstruction during liver transplantation in 599 living-donor liver transplant recipients. Fourteen of the recipients (2.

Surgical treatment of inferior vena cava invasion in patients with renal pelvis transitional cell carcinoma by use of human cadaveric aorta.

We herein report a case of radical nephroureterectomy and replacement of the inferior vena cava (IVC) with ahuman cadaveric aortic graft for a patient with renal pelvis transitional cell carcinoma associated with IVC infiltration. In advanced disease, radical surgery is essential to achieve long-term survival. This case entails the use of another treatment option among the numerous options currently available for the management of patients with advanced renal cancer associated with IVC invasion.

Report of a case of ischemic colitis with bilaterally patent internal iliac arteries after endovascular abdominal aneurysm repair.

During endovascular aneurysm repair (EVAR), interruption of the internal iliac arteries (IIAs) or the inferior mesenteric artery by stents or embolization is thought to cause colon ischemia. To minimize this risk, attempts have been made to preserve the IIAs using iliac branch devices or IIA revascularization. Here we present our experience of colon ischemia after EVAR in a patient with bilaterally patent IIAs without evidence of embolism.

More than 7-year survival of a patient following repeat hepatectomy for total 20 colon cancer liver metastases.

A 54-year-old man was transferred with sigmoid colon cancer combined with multiple bilobar liver metastases. Nine metastases were in the left lobe and 5 metastases were in the right lobe. After low anterior resection, all 9 lesions in the left lobe were completely removed by wedge resections.

Embolic stroke after carotid artery ligation during carotid body tumor resection.

This report describes a case of a delayed cerebral embolic infarction, after internal carotid artery (ICA) ligation secondary to carotid body tumor resection. We describe a 34-year-old woman who underwent left ICA ligation during a large carotid body tumor surgery. Immediately after surgery, the patient was neurologically asymptomatic; however, she subsequently developed a cerebral embolic infarction nine hours postoperatively.

Outcomes of salvage procedures for occluded autogenous radiocephalic arteriovenous fistula.

The outcomes of surgical and endovascular treatments for thrombosed access fistulas are variable and provide no definitive indications for treatment choice. We purposed to review our experience in treating thrombosed radiocephalic arteriovenous fistulas (AVFs) and to evaluate the outcome of procedures, including proximal neo-anastomosis (NEO), replacement of the stenosed segment with a polytetrafluoroethylene graft (GI), patch angioplasty (PA), and endovascular procedures (such as percutaneous transluminal angioplasty [PTA]). A total of 117 occluded radiocephalic AVFs were treated by surgery or an endovascular procedure from January 2002 to December 2007.

In situ polytetrafluoroethylene graft bypass for primary infected aneurysm of the infrarenal abdominal aorta.

Background: Reinfection is a major issue of surgical treatment for patients with infected abdominal aortic aneurysm (AAA). The present report describes outcomes after use of our procedure for treating patients with infected aneurysm of the infrarenal abdominal aorta. The procedure involved an in situ polytetrafluoroethylene (PTFE) graft bypass and omental wrapping of the graft.

Surgical treatment of inferior vena cava tumor thrombus in patients with renal cell carcinoma.

Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. Cephalic extension of the thrombus is closely related to perioperative morbidity. We purposed to design a safe and successful surgical strategy through a review of our surgical experience and treatment results in 35 patients (male:female=28:7, mean age=56 yr [32-77]) who underwent IVC thrombectomy with radical nephrectomy between January 1997 and December 2006.

Surgical treatment of primary neuroendocrine tumors of the liver.

Primary neuroendocrine tumor (NET) of the liver is a very rare neoplasm, requiring strict exclusion of possible extrahepatic primary sites for its diagnosis. We have analyzed our clinical experience of eight patients with hepatic primary NET. From January 1997 to December 2006, eight patients with a mean age of 50.

Prognostic impact of sarcomatous change of hepatocellular carcinoma in patients undergoing liver resection and liver transplantation.

Sarcomatous change has been rarely observed in hepatocellular carcinoma (HCC), but it is usually associated with very aggressive tumor behavior and widespread metastasis. To assess the impact of sarcomatous changes, we analyzed the outcomes of 15 patients with sarcomatous HCC after resection (n = 11) or liver transplantation (LT) (n = 4). No imaging findings characteristic of sarcomatous changes were observed.

Effect of a single layer continuous suture between pancreatic parenchyma and jejunum after duct-to-mucosa anastomosis in pancreaticoduodenectomy: a single surgeon's experiences.

Background/aims: The aim of the present study is to ascertain the effect of a single layer continuous suture between pancreatic parenchyma and jejunum after duct-to-mucosa anastomosis in pancreaticoduodenectomy through a single surgeon's experiences.

Methodology: From March 1, 2002 to March 31, 2005, among 512 patients who had pancreaticoduodenectomy at Asan Medical Center, 56 patients who had a single layer continuous suture between pancreatic parenchyma and jejunum after duct-to-mucosa anastomosis were selected consecutively for prospective study.

Results: There were 44 pylorus-preserving pancreaticoduodenectomy, 10 pancreaticoduodenectomy, 2 hepatopancreaticoduodenectomy.

Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein.

Although pancreatoduodenectomy is the standard treatment for periampullary neoplasms, limited pancreas-preserving resections are sometimes performed. This report describes a carcinoid tumor of the ampulla of Vater for which pancreatoduodenectomy was not feasible because of diffuse cavernous transformation of the portal vein (PV) secondary to main PV obliteration of unknown cause. We performed retroduodenal resection of the ampullary carcinoid with total preservation of the pancreas.

Neurologic complications in adult living donor liver transplant recipients.

Background: Neurologic complications (NC) after liver transplantation are not uncommon, with serious complications such as central pontine myelinolysis (CPM), often causing disability.

Objective: We investigated the incidence and features of NC following liver transplantation in adult recipients.

Patients And Methods: We retrospectively reviewed the medical records of 319 adult patients who underwent liver transplantation between January 2004 and May 2005 at the Asan Medical Center.

Preoperative evaluation of biliary anatomy of donor in living donor liver transplantation by conventional nonenhanced magnetic resonance cholangiography.

Detailed preoperative evaluation of the biliary anatomy of the donor in living donor liver transplantation (LDLT) can minimize postoperative morbidity in the recipient and maximize safety for the donor. We prospectively evaluated the diagnostic accuracy and clinical usefulness of nonenhanced conventional magnetic resonance cholangiography (MRC) for depicting the biliary anatomy of LDLT donors. MRC and intraoperative cholangiography (IOC) examinations of 111 donors were performed between August 2005 and February 2006.

Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantation.

Persistance of a large spontaneous splenorenal shunt (SRS) may result in graft failure in adult living donor liver transplantation (LDLT) because it reduces the effective portal perfusion to the partial liver graft by diversion of hepatotrophic portal flow into this hepatofugal pathway. We performed a prospective study to evaluate the efficacy of ligation of left renal vein (LRV) to prevent portal flow steal and the safety of this procedure to the renal function in adult LDLT patients with SRS. Between October 2001 and January 2005, 44 cirrhotic patients with large SRS underwent LDLT with ligation of LRV.

[Surgical treatment of sclerosing hepatocellular carcinoma].

Background/aims: Sclerosing hepatocellular carcinoma (HCC) is an unusual subtype of HCC that is characterized by an embedded dense fibrous stroma in the tubular neoplastic structures. We aimed to assess the surgical approaches and outcomes of sclerosing HCC.

Methods: We retrospectively analyzed the clinicopathologic features of 6 patients with sclerosing HCC who underwent surgical treatment at Asan Medical Center between July 1989 and December 2005.