PURPOSE: To evaluate the effectiveness, patency and safty of a self-expandable nitinol stent for palliative treatment of malignant stricture of gastroesophageal junction. MATERIALS AND METHODS: An esophageal stent was inserted in five consecutive patients with malignant stricture of esophagogastric junction. Histologicaily, four cases were adenocarcinoma, and one was squamous cell carcinoma. The location and severity of stricture were evaluated with gastrografin just before stent insertion. In one patient with past subtotal gastrectomy, esophagography revealed fistulous tract at stricture site. RESULTS: No technical failure or procedural complications occurred, and improvement of dysphagia was noted in all patients soon after stent insertion. On follow up esophagograms performed 3 to 7 days after stent insertion, all stents were completely expanded and unchanged in positions. In one patient with fistulous connection at stricture site, esophagogram immediately after the procedure revealed complete occlusion of the fistula. Three patients died within 4, 7 and 8 consecutive months after stent insertion. Two patients are alive maintaining adequate body weight and passing most diet. CONCLUSIONS: Self-expandable nitinol stent with it's good longitudinal flexibility and efficient radial force was effective in the palliative treatment of dysphagia in patient with malignant stricture at esophagogastric junction.
Adenocarcinoma ; Body Weight ; Carcinoma, Squamous Cell ; Constriction, Pathologic* ; Deglutition Disorders* ; Diatrizoate Meglumine ; Diet ; Esophagogastric Junction ; Fistula ; Follow-Up Studies ; Gastrectomy ; Humans ; Palliative Care ; Pliability ; Stents*

PURPOSE: To evaluate the difference in each procedure time and complication rates related to percutaneous transhepatic biliary drainage(PTBD) via the right and the left hepatic lobe. MATERIALS AND METHODS: We performed PTBD in 120 patients with biliary obstruction below both main hepatic ducts. Of the 120 catheters, 54 were introduced via a left lobe approach and 66 through the right lobe. All procedures were performed under fluoroscopic guidance by the same operator. For each patient, procedure time was recorded prospectively. PTBD related complications were classified as either early(up to 30 days after procedure) or late(after 30 days), and each complication graded as major, or minor according to its intensity. RESULTS: The difference in the mean procedure time(28.8min versus 36.2rain, left versus right approach group) and that in complication rates (37% versus 58%) were statistically significant(p<0.05). Concerning major complications(bile peritonitis, sepsis, massive hemobilia, liver abscess, pyothorax), the percentages related to left and right lobe approach were 1.8% and 10.6%, and concerning minor complications(catheter obstruction or dislodgement, transient hemobilia, persistent fever or pain), the percentages were 36%and 51%respectively. CONCLUSIONS: PTBD via the left lobe approach was superior with short procedure time and low complication rates than the right approach.
Catheters ; Fever ; Hemobilia ; Hepatic Duct, Common ; Humans ; Liver Abscess ; Peritonitis ; Prospective Studies ; Sepsis

In several pathologic conditions of the joints, it is rather frequent to find a swollen joint. The authors performed an analysis of the joint fluid proteins from 20 cases of rheumatoid arthrit is and 20 normal Kore an adults with the object of evaluating the significance of it s clinical application. The study was done with Beckman Model R System, Durrum type cell, and scanned with Model RB Analytrol. Scheicher and Schuell 2043-A paper was used with diethyl barbituric acid-sodium diethyl barbituratebuffer, pH 8.6, ionic strenght 0.075 and stianed with 0.1% bromphenol blue. The results obtained were as follows: 1) The amount of total protein was significantly increased with average of 4.80 + 1.249gm% in comparison with 2.34 + 0.553gm% in normal group. 2) Albumin fraction showed the average of 41.86 + 6.219% in comparison with 64.85 + 5.288% in normal group. 3) Alpha 2 globulin fraction disclosed the average of 10.19 + 3.379% in comparison with 4.24 + 1.158% in normal group, which was significantly increased one. 4) Gammaglobulin fraction was also significantly elevated with the average of 21.51 + 8.942% in comparison with 11.70 + 1.923% in normal group. 5) There was noted a decreased A/G ratio, the average of 0.74 + 0.196, in comparison with 1.911 + 0.430 in normal group.
Adult ; Arthritis, Rheumatoid ; Bromphenol Blue ; Humans ; Hydrogen-Ion Concentration ; Joints

Corneal ulcerations are divided into two morphologic types: central and marginal. Marginal corneal ulcerations are characterized by focal, muItifocal, multifocal or diffuse ulcerative, infiltrative, or vascular involvement of the peripheral cornea, and the exact pathogenesis of these ulcerations is not clearly understood but infectious, toxic or autoimmune factors may be involved. The authors treated one peripheral corneal ulcer patient, no respond to steroid and antibiotic therapy, with lamellar keratoplasty and had a good result.
Cornea ; Corneal Transplantation* ; Corneal Ulcer* ; Humans ; Ulcer

Primary carcinoma of the uterine tube is one of the least common gynecologic malignancies with a reported incidence of approximately 0.3%. As a result of it, the experience of any one physian is limited. Almost all cases are adenocarcinoma and the cilinical presentation is generally nonspecific, of which the most common symptom is postmenopausal vaginal bleeding. Primary fallopian tube carcinima is infrequently diagnosed before explolatory laparotomy and the majority of patients have extensive disease at diagnosis. We have experienced a case of fallopian tube cancer and report with brief review of literature
Adenocarcinoma ; Diagnosis ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Incidence ; Laparotomy ; Uterine Hemorrhage

Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck

A case of multiple hamartomas of the unilateral chest wall in a four month old infant is presented. There have been a few reports on the CT findings of the chest wall hamartoma in infancy. We describe bone changes of the ribs and mineralization of this rare tumor on the CT scan, and the locations of two separate masses.
Hamartoma ; Humans ; Infant ; Miners ; Ribs ; Thoracic Wall* ; Thorax* ; Tomography, X-Ray Computed

We have experience with a case of eclampsia under general anesthesia for primary Cesarean section. The patient had fits 6 times for 9 hours at home and hospital. The Apgar score of the neonatal infant was five and seven points at one and five minutes after delivery, respective1y. After the end of the operation, the patient had attacks, of fits 2 times and a semicomatous mental state in the recovery room. Then l2 hours later the patient recoveried completely without any special complications. A review of the literature is reported with the incidence etiology and treatment of the eclampsia during pregnancy.
Anesthesia, General* ; Apgar Score ; Cesarean Section* ; Eclampsia* ; Female ; Humans ; Incidence ; Infant ; Pregnancy ; Recovery Room

Spinal anesthesia is a type of regional anesthesia obtained by blocking the spinal nerves with the introduction of local anesthetic solutions into the subarachnoid space. Historically, in 1885 Corning accidentally introduced spinal anesthesia and in 1898 August Bier produced true spinal anesthesia in animal and man for the first time. Even though spinal anesthesia is widely used because of many advantages, headache, the most common untoward complication, has been said to be the greatest single deterrent to the patient who is considering this anesthetic technique. The obstetric patient is more likely to suffer from headache than the surgical patient after spinal anesthesia. Authors observed the incidence of post-spinal headache in 288 patients who received spinal anesthesia for cesarean section at department of anesthesiology in Ewha Womans University Hospital from March 1979 to February 1980. The patients were divided into 2 groups according to the needle size, used to perform spinal tap i.e. 22 and 25 gauge (G). The results obtained were as follows; 1) Among 288 cases, 63 cases underwent spinal anesthesia with 22 G and 225 cases with 25 G. 2) The indications for cesarean section were previous cesarean section(36. 8%), cephalopelvic disproportion(20.5%), malpresentation(10. 7%) and placenta previa(4. 2%) in order of frequency. 3) In the age distribution, the majority(72.6%) was in 20~29 years age group. 4) The incidence of headache was higher in the group of 22 G(17.8%) than in 25 G group (9. 8%), but there was no statistical significance. 5) The onset of headache was within 2 or 3 days after spinal anesthesia in both groups. 6) In the severity of headache, the group of larger size needle showed headache worse than that of small size needle. 7) In the location of headache, generalized headache developed in 54. 5% of cases in the group of 22 G needle and frontal headache developed in 40. 9% in the group of 25 G needle. 8) Ocular complication associated with headache noted in 2 cases of the group of 25 G needle. There was no auditory complication.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, Spinal ; Anesthesiology ; Animals ; Cesarean Section* ; Clinical Study* ; Female ; Headache* ; Humans ; Incidence ; Needles ; Placenta ; Pregnancy ; Spinal Nerves ; Spinal Puncture ; Subarachnoid Space ; Zea mays

The authors have experience with a case of cephalo-pelvic disproportion associated with acute hapatitis during fullterm pregnancy under the spinal anesthesia for Cesarean section at the Ewha Womans University Hospital. The past ohstetric history revealed spontaneous abortion 2 times and no special medication and blood transfusion. During operation the patients condition was unstable due to severe hypotension after spinal anesthesia. At 14 hours after the end of the operation, the patient expired because of acute renal shut down accompanied by continuous vaginal, bleeding and oozing from the operation wound. The neonatal infant expired also. A review of the literature is reported with the incidence, eriology, signs, symptoms and treatment of the liver disease during pregnancy.
Abortion, Spontaneous ; Anesthesia, Spinal* ; Blood Transfusion ; Cesarean Section* ; Female ; Hemorrhage ; Hepatitis* ; Humans ; Hypotension ; Incidence ; Infant ; Liver Diseases ; Pregnancy ; Wounds and Injuries