Extrinsic compression of left iliac vein does not predict the development of post thrombotic syndrome in left side deep venous thrombosis / 대한외과학회지

PURPOSE: Left side deep venous thrombosis (DVT) is associated with May-Thurner's anatomical variation and is often instigated by invasive treatment. The aim of this study is to analyze the influence of left iliac vein narrowness on incidence of post thrombotic syndrome (PTS) that developed after left side DVT. METHODS: Forty-one left side DVT cases that were followed up for more than 1 year were enrolled. The iliac vein narrowness was measured by the shortest distance from the right iliac artery to the 5th lumbar vertebra overlying left iliac vein in computed tomography (CT) scan. The incidence of PTS was measured by phone-call history taking for specific symptoms of PTS. The means of the shortest distance were compared by independent t-test. RESULTS: The number of PTS cases was eleven (26.8%). The level of thrombus, demographic data and other risk factors were similar in both PTS and non-PTS groups except the mean risk factor score. The mean of the shortest distance of PTS group and non-PTS group were 5.56 mm and 5.89 mm, respectively. CONCLUSION: The degree of left iliac vein narrowness measured by the shortest distance from the right iliac artery and the 5th lumbar vertebral body was not a predictive factor for PTS.

Impact of Distance from the Right Iliac Artery to the Lumbar Vertebra in Left Side Deep Venous Thrombosis / 대한혈관외과학회지

PURPOSE: The aim of this study is to evaluate how much influence iliac vein compression exerts on the clinical feature of deep venous thrombosis (DVT). METHODS: One hundred five cases of lower extremity DVT were enrolled. The cases were grouped by location of the thrombus, left/right and inferior vena cava, iliac vein (IV), femoral vein (FV), popliteal vein, and calf vein. The estimated frequency was calculated by means of that the numbers of each goup were divided by the group's mean of DVT risk score. The minor distance from the right iliac artery to the fifth lumbar vertebral body overlying the left iliac vein was measured in computed tomography. Correlation of the severity and the minor distance was evaluated. RESULTS: Left, right, and bilateral DVT were represented in 66, 26, and 13 cases, respectively. Estimated frequencies were 2, 6.47, 5.47, 2.08, and 0.96 in the left side and 2, 1.44, 2.5, 1.33, and 1 in the right, respectively. Statistics significance was seen at the IV and FV levels. The means of minor distances in millimeters were 4.88, 3.98, 6.13, 6.20, and 4.20 in the left and 2.50, 7.00, 5.20, 7.33, and 6.50 in the right, respectively. Significance was seen only at the IV level. DVT severity and the minor distance could not be correlated with statistical significance. CONCLUSION: We consider that May-Thurner's anatomical changes impacts the DVT prevalence only at the proximal vein. We also suggest that the compression of the left iliac vein might be a contributing factor for developing DVT but not for severity of the DVT.

The Usefulness of the Computed Tomography for Diagnosing DeepVenous Thrombosis of the Lower Extremities

PURPOSE: This study aims to access the usefulness of indirect computed tomographic venography (CTV) after performing computed tomographic pulmonary angiography (CTPA) to detect deep venous thrombosis. METHODS: Eighty six patients who were diagnosed with deep venous thrombosis (DVT) were retrospectively enrolled in this study. All the patients had CTPA & CTV performed within 24 hours after Doppler ultrasound (US). The CTV was compared with Doppler US for their ability to diagnose DVT. Pulmonary embolism (PE) and other findings that were detected by CTPA & CTV were analyzed. RESULTS: Among 86 patients, 83 had thrombi detected by Doppler US. CTV did not detect DVT in 11 of the 83 patients. Among the 11 patients, 8 had below the knee thrombosis, which was not in the scan area of CTV. In 2 patients, their Doppler US results could not be guaranteed. One case was a false positive result on Doppler US. The results for determining the thrombi level between Doppler US and CTV were roughly concordant. In addition to DVT or PE, 32 new lesions in 27 patients were incidentally detected by CTPA & CTV. CONCLUSION: Compared with Doppler US, CTPA & CTV are not inferior to detect DVT of the lower extremities and these modalities can also provide information about incidental disease, as well as pulmonary embolism.

Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs) / 소아과

PURPOSE: The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. METHODS: Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. RESULTS: Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7: 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. CONCLUSION: Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.

Detection of black-pigmented bacteria in infected root canals / 대한치과보존학회지

Black-pigmented bacteria have been implicated in the endodontic infections. This group of microorganisms includes Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, and Prevotella nigrescens. The organisms display a wide variety of virulence factors that may be pertinent to acute endodontic infections. The aim of this study was to identify P. endodontalis, P. gingivalis, P. intermedia, and P. nigrescens by using special potency disk test, filter paper spot test, 16S rRNA gene-directed PCR, and API 32A. Microbial samples were collected from root canals of 33 intact teeth with necrotic pulp and/or apical periodontitis. Conventional laboratory methods were used for identification of the strains of black pigmented bacteria. Eighteen of 33 samples were positive for the growth of black-pigmented bacrteria. Five colonies were cultured from each pure cultured colonies from Brucella agar plate. Seventy seven colonies were positive for the growth of black-pigmented bacteria. Thirty three of 77(42.6%) were identifed as P. nigrescens, 10 of 77(12.9%) were P. gingivalis, 6 of 77(7.8%) were P. endodontalis, 10 of 77(12.9%) were P. intermedia. On the contrary the reference strains of P. nigrescens, experimental strains of P. nigrescens was sensitive to kanamycin in special potency disk test. 16S rRNA gene PCR and API test after rapid presumptative identification methods, such as special potency disk test and filter paper spot test, would be accurate detection methods for black-pigemented bacteria.