Delayed strut fracture of sirolimus-eluting stent: a significant problem or an occasional observation?

In-stent restenosis after implantation of sirolimus-eluting stents (SES) still occur in some cases and stent fracture was recently suggested as a new potential mechanism of restenosis. We report a case of delayed stent strut fracture after percutaneous coronary intervention with SES. Until now, three cases regarding Cypher stent fracture have been reported in the literature.

Does a carbon ion-implanted surface reduce the restenosis rate of coronary stents?

Background: Neointimal hyperplasia and resulting restenosis limit the long-term success of coronary stenting. Heavy metal ions induce an inflammatory and allergic reaction, and result in in-stent restenosis. However, a carbon ion-implanted surface might prevent heavy metal ions from diffusing into surrounding tissue.

Intracoronary aspiration for bailout management of the no-reflow during percutaneous coronary intervention.

The no-reflow phenomenon is frequently associated with adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). We describe two cases in which the no-reflow phenomenon developed during PCI and was successfully resolved by direct intracoronary aspiration using the Export aspiration catheter.

Two cases of subintimal angioplasty with proximal stent implantation for long superficial femoral artery occlusions.

Subintimal angioplasty is a simple and safe alternative to conventional intraluminal angioplasty for the recanalization of diffuse long femoropopliteal occlusions. However, long-term patency rates are unsatisfactory despite the high initial technical success rates. Two cases of occluded left superficial femoral arteries are presented in which subintimal angioplasty with proximal stent implantation was successfully performed.

Endovascular therapy combined with immunosuppressive treatment for occlusive arterial disease in patients with Takayasu's arteritis.

Purpose: To evaluate the feasibility and efficacy of endovascular therapy combined with immunosuppression for the treatment of arterial occlusive disease in patients with Takayasu's arteritis (TA).

Methods: From January 1998 to June 2003, 25 patients (22 women; age 37.8+/-15.

Percutaneous interventional treatment of extracranial vertebral artery stenosis with coronary stents.

Stenosis of extracranial vertebral artery (VA) is not an infrequent lesion, and it can pose a significant clinical problem. However, the standard treatment for a significant VA stenosis has still not been established. Here in this study, we report our experiences of VA stenting in 25 patients (age 56.

Comparison of a percutaneous separate stent endograft and a conventional thoracic stent-graft for endovascular repair of type B aortic dissection.

Purpose: To compare the immediate and midterm outcomes of aortic dissection repair with a separate stent endograft (SSE) versus a conventionally constructed thoracic stent-graft.

Methods: The records of 35 patients treated for type B aortic dissection from September 1997 to April 2003 were reviewed. Seventeen patients (12 men; mean age 58.

Identification of genes responsive to apoptosis in HL-60 cells.

Aim: To identify genes responsive to apoptosis in HL-60 cells treated by homoharringtonine.

Methods: cDNA microarray technology was used to detect gene expression and the result of microarrays for genes (TIEG and VDUP1) was confirmed by Northern analysis.

Results: Seventy-five individual mRNAs whose mass changed significantly were identified.

A beam tracing method for interactive architectural acoustics.

A difficult challenge in geometrical acoustic modeling is computing propagation paths from sound sources to receivers fast enough for interactive applications. This paper describes a beam tracing method that enables interactive updates of propagation paths from a stationary source to a moving receiver in large building interiors. During a precomputation phase, convex polyhedral beams traced from the location of each sound source are stored in a "beam tree" representing the regions of space reachable by potential sequences of transmissions, diffractions, and specular reflections at surfaces of a 3D polygonal model.

Single-level dynamic spiral CT of hepatocellular carcinoma: correlation between imaging features and density of tumor microvessels.

Aim: To investigate the correlation of enhancement features of hepatocellular carcinoma (HCC) revealed by single-level dynamic spiral CT scanning (DSCT) with tumor microvessel density (MVD), and to determine the validity of DSCT in assessing in vivo tumor angiogenic activity of HCC.

Methods: Twenty six HCC patients were diagnosed histopathologically. DSCT was performed for all patients according to standard scanning protocol.

Safety of anti-hepatitis B core antibody-positive donors for living-donor liver transplantation.

Serologic evidence of resolved hepatitis B virus (HBV) infection (HBV surface antigen negative, anti-HBV core antibody [HBc] positive) in a liver donor can be regarded as an occult infection with episomal HBV in the liver. The purpose of this study was to evaluate the safety of anti-HBc-positive living donors. Between March 2001 and January 2002, 127 donors underwent hepatectomy for living-donor liver transplantation at Asan Medical Center.

Approach to anatomic variations of the graft portal vein in right lobe living-donor liver transplantation.

Right lobe living-donor liver transplantation (LDLT) is often not attempted in donors with anomalous portal venous branching (APVB). The authors describe their experience with portal vein (PV) reconstruction in 17 cases of APVB in right lobe LDLT. From July 1997 to December 2001, 214 right liver LDLT were performed at the Asan Medical Center.

Adult-to-adult living donor liver transplantation at the Asan Medical Center, Korea.

Between February 1997 and December 2001, 311 adult-to-adult living donor liver transplants (A-A LDLTs) were performed at the Asan Medical Center for patients above 20 years of age. Indications for A-A LDLT were: chronic hepatitis B (203), chronic hepatitis C (5), hepatocellular carcinoma (64), alcoholic cirrhosis (9), cryptogenic cirrhosis (4), secondary biliary cirrhosis (5), primary biliary cirrhosis (1), Wilson' s disease (2), autoimmune hepatitis (1), hepatic tuberculosis (1), cholangiocarcinoma (1), fulminant hepatic failure (14) and primary non-function of cadaveric liver graft (1). Of 311 A-A LDLTs, 36 were of medical high urgency, 20 were for acute and subacute hepatic failure, 15 were for hepato-renal syndrome and 1 was for primary non-function.

Transjugular intrahepatic portosystemic shunt for intractable posthepatectomy ascites.

We report two cases of transjugular intrahepatic portosystemic shunt for control of intractable ascites after resection of cirrhotic livers. The first case was a 46-year-old male who had undergone right lobectomy of the liver for a small hepatocellular carcinoma. His liver function had recovered within a week after the operation, but ascites drainage of 1-4 L/day persisted for more than a month despite vigorous medical therapy.

A case of primary non-function following adult-to-adult living donor liver transplantation.

We report a case of primary non-function of graft liver following adult-to-adult living donor liver transplantation. The recipient was a 43-year-old male with hepatitis B-associated liver cirrhosis. The donor was a 28-year-old brother of the recipient.

Congestion of right liver graft in living donor liver transplantation.

Background: Left liver graft from a small donor will not meet the metabolic demands of a larger adult recipient. One solution to this problem is to use a right liver graft without a middle hepatic vein (MHV). However, the need for drainage from the MHV tributaries has not yet been described.

Factors affecting insertion time and patient discomfort during colonoscopy.

Background: Successful colonoscopy depends on insertion of the instrument to the cecum, precise observation, and minimal patient discomfort during the procedure. The aim of this prospective study was to determine whether certain variables are associated with insertion time and patient discomfort during colonoscopy.

Methods: Nine hundred nine consecutive colonoscopic examinations performed by a single endoscopist in patients without obstructive disease of the colorectum were analyzed.

One hundred and eleven liver resections for hilar bile duct cancer.

A positive correlation between absence of residual tumor at resection margins and long-term survival in the treatment of hilar bile duct carcinoma has encouraged some surgeons to use a more radical approach, including liver/portal vein resection and combined pancreatoduodenectomy. However, if liver resection is associated with significant morbidity and mortality, it may not produce any overall benefit. This review was undertaken in an attempt to determine whether liver resection is a safe procedure and whether if has any beneficial effect over that of local bile duct excision alone, in terms of achieving curative resection and long-term survival.

Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels.

Background: We investigated the constituting collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor thrombosis of hepatocellular carcinoma (HCC) by using contrast-enhanced spiral computed tomographic (CT) examination.

Methods: Fifty-four histopathologically proven HCC patients with tumor thrombosis-induced CTPV were retrospectively included and assigned to cirrhosis negative (n = 31) and positive (n = 23) groups. Another 15 cirrhotic patients with portal hypertension but no HCC and CTPV were used for comparison.