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

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

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

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

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

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

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

Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59~60 Gy in 28~30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not stastically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer
Anus Neoplasms* ; Chemoradiotherapy* ; Constriction, Pathologic ; Drug Therapy ; Follow-Up Studies ; Humans ; Pelvis ; Protestantism ; Radiotherapy ; Survival Rate

Placement of the self-expandable metallic stents for palliative treatment of malignant esophagogastric strictures has been thought to be easy, fast and effective method than conventional methods (bypass procedures, radiation therapy, laser treatment, esophageal intubation, etc.). The expandable metallic stent tubes were found to overcome some of the limitations of nonexpandable conventional tubes. Their implantation is better tolerated and safer than that of nonexpandable tubes, because the risks of migration and perforation are lower.On our knowledge, there has been no report of pyloric obstruction after this metallic stent insertion.We hereby report a case of pyloric obstruction caused by a migrated self-expandable metallic stent for palliative treatment of malignant esophageal stricture.
Constriction, Pathologic ; Deglutition Disorders* ; Esophageal Neoplasms ; Esophageal Stenosis ; Intubation ; Laser Therapy ; Palliative Care ; Stents*