Adolescent ; Constriction, Pathologic ; Coronary Vessel Anomalies ; therapy ; Humans ; Male ; Stents

A clinical evaluation of the chemotherapy (INH, PAS and SM) on the 16 patients with renal tuberculosis for the period of 9 months to 4 years was performed. The results obtained were summarized as follows; 1) Of the 16 cases with renal tuberculosis, minimal lesion was found in only one case. moderately advanced in 6, and far advanced in 9. 2) In the case of the minimal lesion, no tubercle bacilli were detected by microscopic examination .after the triple therapy for 3 months. It was suggested that the minimal lesion would require at 1eaet 6 months to be cured by the chemotherapy. 3) Five of the 6 cases with the moderately advanced lesion were cured (83%), and at least 12 months were required for the moderately advanced lesion to be cured. 4) In the 9 cases of the far advanced lesion, only one case was cured, two were on the healing process, three were exacerbated even after the therapy for 6 months, and the remaining three were progressed to those with non-visualizing kidneys 9 to 12 months after the therapy. 5) Five of the 6 exacerbated far advanced lesions were associated with ureteral strictures, and thus the ureteral stricture may be an important factor in determining the prognosis of the renal tuberculosis. For the far advanced lesions progressed to the non-visualizing kidneys in spite of the chemo-therapy, surgical interventions are likely to be more favorable.
Constriction, Pathologic ; Drug Therapy* ; Humans ; Kidney ; Prognosis ; Tuberculosis, Renal* ; Ureter

Humans ; Tenosynovitis/therapy* ; Tendons ; Constriction, Pathologic ; Primary Health Care

Constriction, Pathologic ; Fibrosis ; Humans ; Lung ; Mediastinitis/therapy* ; Sclerosis

Humans ; Renal Artery ; Constriction, Pathologic ; Hypertension, Renovascular/therapy* ; Vascular Diseases ; Renal Artery Obstruction/therapy* ; Embolization, Therapeutic

The stricture of the calyx, pelvis or ureter due to renal tuberculosis had been managed like nephrectomy, partial nephrectomy, ureteroileoneocystoplasty or even pancaliceal-ileoneocystoplasty. To salvage the renal parenchyme and to treat the tuberculous renal caliceal strictures, percutaneous endocalicotomy with or without endopyelotomy was performed in 10 cases from Aug. `90 to Jan. `92. The sites of stricture were mainly upper calyx in 6 cases and lower in 4. A cold knife was used to incise the stricture and a stenting 2-sectioned(14 Fr.) endopyelotomy catheter was retained for 6 to 8 weeks. Postoperative intravenous pyelography revealed marked shrinkage of the dilated calyx in 7 cases. moderate in 1 and no change in 2(success rate, 80%). In failed 2 cases, 1 cases was performed partial nephrectomy and the other was following. There was no significant complications except 1 case of upward migration of D-J catheter. In conclusion, endocalicotomy is safe, less invasive, successful (in cases that guide wire could pass) and parenchyme preserving procedure. The retregrade pyelography is mandatory just before the surgery because stricture can be progressed during Anti-Tbc chemotherapy.
Catheters ; Constriction, Pathologic* ; Drug Therapy ; Nephrectomy ; Pelvis ; Stents ; Tuberculosis, Renal ; Ureter ; Urography

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

BACKGROUND: The effects of intravenous thrombolytic therapy depend on maintaining the patency of infarct-related artery in acute myocardial infarction. Thirty-two patients with acute myocardial infarction and ST segment elevation were studied to determine the usefulness of early resolution of ST segment elevation as an index of recanalization after intravenous urokinase administration. METHOD: 32 patients(male 24, female 8, mean age+/-standard deviation 62+/-11 years) were given intravenous urokinase therapy for acute myocardial infarction. Patients were classified into two groups according to changes of Summation operator ST segment elevation : early resolution(group I)=resolution to <25% of peak value within 12 hours of commencing urokinase therapy : no resolution(group II)=decreased in Summation operator ST segment elevation to > or =25% of peak value. The relationship between early changes in Summation operator ST segment elevation, time to peak creatinine kinase(CK), peak CK, changes of QRS score and & stenosis of infarct-related artery were investigated in both group. RESULTS: 1) The Summation operator ST segment elevation decreased by more than 75% of initial Summation operator ST within 12 hours after urokinase administration in 13 patients(40.6%). 2) The initial Summation operator ST segment was higher in the early resolution group than in the nonresolution group(26.0+/-4.2 vs 15.2+/-1.9mm, p<0.05). 3) The initial QRS score in both groups were not different significantly(7.2+/-0.9 vs 5.4+/-0.6 p<0.05), but QRS score decreased in the early resolution group and did not change in the no resolution group(-0.69+/-0.23 vs 0.63+/-0.16, p<0.05). 4) The early resolution group showed higher peak CK level(2409.2+/-347.7 vs 1445.2+/-280.4, p<0.05) and earlier peak time(10.6+/-1.0 vs 24.2+/-4.6, p<0.05). 5) There was no total occluded artery in both group, but the early resolution group tended to less stenosis in infarct related arteries(66.7+/-80 vs 86.7+/-3.3%, p=0.13) in predischarge coronary angiography. CONCLUSIONS: Early ST resolution after intravenous urokinase administration in acute myocardial infarction is an useful clinical index of recanalization or benefit induced by thrombolytic therapy.
Arteries ; Constriction, Pathologic ; Coronary Angiography ; Creatinine ; Female ; Humans ; Myocardial Infarction* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

During 5 years, from January 1976 to December 1980, clinical observation on management of ureteral stones was made on 169 admitted patients with ureter stones. Following results were obtained. 1) Among total 1054 in-patients, 169 cases (16.0%) had ureteral stones, and male to female ratio was 2 : 1. 2) Patients with 20-40 of his age was half. 3) On seasonal distribution, it was most prevalent on Summer. 4) 113 cases were located on lower ureter, and laterality was even. 5) Most common symptoms were renal colic and hematuria (91.8%) 6) Ureterolithotomy was done in 127 cases. In 86 cases of lower ureter stones, less than 1cm in size. conservative fluid therapy and cystoscopic extraction was successful in 44 cases. 7) Post-operative complications were urinary leaking (16 cages), wound infection(12 cases), hematuria (3 cases), ureteral stricture (1 case), and pyelonephritis (1 case).
Constriction, Pathologic ; Female ; Fluid Therapy ; Hematuria ; Humans ; Male ; Pyelonephritis ; Renal Colic ; Seasons ; Ureter* ; Wounds and Injuries

PURPOSE: Salvage procedures for a dysfunctional arteriovenous fistula (AVF) are defined as operation or percutaneous balloon angioplasty (PTA) for the AVF is inadequate for performing hemodialysis. This retrospective study was performed in order to identify the appropriate salvage treatment modality. METHODS: From April 2001 to October 2007, 132 salvage procedures in 100 patients were performed. We analyzed the overall cumulative patency rates of both the procedures and we compared them according to the type of primary AVF and the site and distribution of the stenoses. RESULTS: Fifty eight patients underwent operation, and 74 patients underwent PTA. The initial success rate was 77.59% for operation and 83.78% for PTA. The one year cumulative patency rates of operation and PTA were 46.11% and 21.62%, respectively (P=0.00). For the patients whose AVF had been created using autogenous vein, the one year cumulative patency rates of operation and PTA were 49.72% and 21.15%, respectively (P=0.04). According to the location and distribution of the stenoses, 56 patients (64.4%) with an autogenous AVF had juxta-anastomotic lesion. Among them, 23 patients underwent operation and 33 patients underwent PTA. The 1 year cumulative patency rates for these patients were 66.63% and 12.12%, respectively (P=0.00). For the treatment of the diffuse and multiple stenoses of the autogenous vein, PTA (n=14) showed a better patency rate than that of operation (P=0.00). CONCLUSION: Salvage therapy for a dysfunctional fistula prolonged their life span. Operation was superior to PTA for a juxta-anastomotic lesion of an autogenous AVF, but PTA had benefit over operation for the cases with diffuse and multiple stenoses.
Angioplasty, Balloon ; Arteriovenous Fistula ; Constriction, Pathologic ; Fistula ; Humans ; Renal Dialysis ; Retrospective Studies ; Salvage Therapy ; Veins