No abstract available.
Pancreas*

PURPOSE: This study was designed to evaluate usefulness of intravenous digital subtraction angiography (IV-DSA) in detection of peripheral arterial obstructive disease(PAOD) and in follow-up of percutaneous transluminal angioplasty(PTA). MATERIALS AND METHODS: 35 Patients who had clinical symptoms and signs of compromised lower extremity perfusion, was screened with IV-DSA and then performed confirmative conventional angiography. We obtained sensitivity, specificity and accuracy of IV-DSA by comparing the findings of IV-DSA with those of conventional angiography. 21 patients who had been performed successful PTA, were foliowed-up with IV-DSA in 3, 6, 12months. We studied patency rate and factors that influenced restenosis. RESULTS: The sensitivity, specificity and accuracy of IV-DSA were 100%, 97%, 97% in lilac artery, 92%, 96%, 93% in femoropopliteal artery, 85%, 75%, 70% in proximal tibioperoneal artery retrospectively. IV-DSA follow up after PTA showed patency rate of 67% in first 3month, 67% in 2nd 3month, 60% in next 6month. Longer length and more irregular surface of the stenotic site, and higher incidence of run-off of vessel and of residual stenosis in the patients with restenosis were noted. CONCLUSION: High sensitivity, specificity and accuracy of IV-DSA in evaluating PAOD suggest that IV-DSA is useful in screening, planning therapy and following up after PTA.
Angiography ; Angiography, Digital Subtraction ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity

It has long been an accepted policy to employ radiation therapy as initial treatement of choice for most casesof invasive carcinoma of cervix uteri. But, complications following radiotherapy were troublesome problem fot thepatients cured by radiation therapy. The aim of the present study is to present the types and rate of complicationsand to evalute the contributing facors induced the radiation complications. The aim of the present study is topresent the types and rate of complications and to evalute the contributing factors induced the radiationcomplications. 957 cases of invasive carcinoma of cervix uteri receiving radiation therapy were analyzed. Theconclusions are as follows; 1. Bowel complications developed in 96 cases (10.03%). 2. 86% of all bowelcomplications appeared during the first 18 months and most frequently seen after 6 to 12 months(40.03%). 3. Thefrequency of complicaiton was higher in older age and larger irradiation dose, but there is no apparentcorrelation between stage and the occurrence of complications. 4. Portal combination was also a contributingfactor. Highest frequency was noted in AP & PA parallel opposing portals followed by 4 oblique portals and boxtechnique.
Cervix Uteri ; Female ; Radiotherapy

This paper contains the results of clinical and neuroradiologic studies in 9 cases of histopathologicallyverified intracranial cavernous hemangiomas. The most common clinical presentations were focal seizure andheadache which were accompained by focal neurologic deficits. Skull films revealed abnormality in 3 cases andcerbral angiography revealed an avascular area in 8 cases, but both were of little diagnostic significance. CTusually demonstrated a hyperdense, cystic and calcified lesion without significant mass effect, and mild degereeof tubular or ring like enhancement after contrast injection. The follow-up CT findings in 4 cases over a 6-monthperiod were compatible to repeated minute hemorrhage and resolution. The above clinical and CT findings and , ifpossible, repeated CT could suggest the diagnosis of cavernous hemangioma and provide the proper management,including the avoidance of unnecessory radiation therapy and biopsy related complications.
Angiography ; Biopsy ; Diagnosis ; Follow-Up Studies ; Hemangioma, Cavernous ; Hemorrhage ; Neurologic Manifestations ; Seizures ; Skull

No abstract available.
Cyclosporine ; Necrobiosis Lipoidica ; Necrobiotic Disorders

BACKGROUND: Total occlusion of the infrarenal abdominal aorta is a very rare disease in clinical practice. The clinical outcome may be poor unless management is attempted promptly. Surgical bypass has been recommended as the treatment of choice for these lesions. However, there was relatively high surgical mortality and morbidity associad with aorto-bifemoral bypass graft in patients with other systemic disease, especially coronary artery disease. As a result, the use of, thrombolysis with percutaneous transluminal angioplasty (PTA) has recently been extended to this disease as an alternative method to surgery. PTA is technically simpler with less morbidity and mortality than surgery.We report our experience with thrombolysis and balloon angioplasty of total aortic occlusion in 14 patients between March 1991 and December 1996. METHODS: Fourteen patients, whose mean age was 59+/-13 years (11 male, 3 female), serve as the study's patients. Aortography was introduced via transbrachial artery. The end hole multipurpose catheter with guidewire was introduced into the thrombotic portion of the total occlusion. Urokinase was infused into the thrombus through the catheter if there were no contraindications. in sysremic thrombolysis. Thrombolytic therapy was continued until the thrombi was resolved and flow was restored. Balloon dilatation was followed in residual stenotic lesions. Stents were implanted in case of suboptimal results after ballooning. RESULTS: Clinical findings were resting leg pain in 6 patients, gangrene in 5 patients, and claudication in 3 patients. The causes of aortic occlusion were thromboembolism in 4 patients and thrombosis of an atherosclerotic aorta in 10 patients. Location of obstruction was below the renal artery in all cases. The clinical outcome of interventional therapy was successful in all cases except one patients. Operative treatment was undertaken in 2 cases because they could not received thrombolytic therapy due to contraindication and complication of thrombolytic therapy (gastrointestinal bleeding). Near normal revascularization was achieved in 3 patients by thrombolytic therapy only. PTA was performed at the stenotic after thrombolytic therapy in 4 patients. Stenting were performed at the stenotic sites after balloon dilatation in another 4 patients. There was bleeding complication in one case. CONCLUSIONS: Interventional therapy such as thrombolytic therapy with PTA is an effective and safe treatment modality for abdominal aortic total occlusion in selected cases. These techniques were very useful in some high risk patients who received surgical bypass procedures.
Angioplasty ; Angioplasty, Balloon ; Aorta ; Aorta, Abdominal* ; Aortography ; Arteries ; Catheters ; Coronary Artery Disease ; Dilatation ; Gangrene ; Hemorrhage ; Humans ; Leg ; Male ; Mortality ; Rare Diseases ; Renal Artery ; Stents ; Thromboembolism ; Thrombolytic Therapy ; Thrombosis ; Transplants ; Urokinase-Type Plasminogen Activator

Out of 75 patients who were admitted to our hospital because of abdominal trauma and were undergone theprocedures such as ultrasonography and/or CT scan within 24 hours of abdominal trauma due to suspected abdominalorgan injury. We analyzed the results of 38 patients who were confiremd of diagnosis by operation, follow-up CTscan or ultrasonography. 1. In the abdominal organ injury, solid organ injury consists of 8 cases of spleenlaceration, 1 of splenic subcapsular hematoma, 7 of hepatic laceration, 7 of pancreas laceration, 3 of renallaceration, and 3 of subcapsular hematoma of kidney. 2. In addition, there were 7 bowel and/or mesentericlaceration, 2 diaphragmatic hernia, and 1 urethral rupture. 3. 2 cases fo retroperitoneal hematoma and 1 case inwhich hemoperitoneum occurred without abdominal organ injury were confirmed by follow-up CT or ultrasonography. 4.In all of the 4 patients with multiple organ injury, pancreatic laceration was associated. 5. In abdominal traumapatients, ultrasonography or CT can be used to survey rapidly the entire abdomen for possible associated injury,and be of great help to clinicians in identifying the patients who need immediate surgery or in minimizing theincidence of unnecessary emergency abdominal exploration.
Abdomen ; Diagnosis ; Emergencies ; Follow-Up Studies ; Hematoma ; Hemoperitoneum ; Hernia, Diaphragmatic ; Humans ; Kidney ; Lacerations ; Pancreas ; Rupture ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Prostate* ; Testis*

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

PURPOSE: c-erbB2 encodes 185 kDa oncoprotein with tyrosine kinase activity and has homology to the epidermal growth factor receptor. c-erbB2 proto-oncogene is found to be overexpressed in approximately 20 to 30% of primary breast cancer and has been associated with poor prognosis and lower response to conventional chemotherapy. MATERIALS AND METHODS: We perfonned a study on 40 infiltrating ductal breast cancers treated with primary surgery and adjuvant chemotherapy. We investigated c-erbB2 expression by immunohistochemistry in paraffin-embedded tissue using polyclonal antipeptide antibody(DAKO). We evaluated the relationships between its expression and the results after over 6 cycles of adjuvant chemotherapy including cyclophosphamide, methotrexate and 5-FU. RESULTS: The median age at diagnosis was 43 years and the median follow-up time was 47.3 months. Thirteen(32.1%) of 40 patients showed the c-erbB2 overexpression in the external domains of protein. There were no correlations among c-erbB2 amplification and other prognostic factors such as hormonal receptors, histologic grade and tumor size. Estrogen receptor and progesterone receptor showed tendency of inverse correlation with c-erbB2 overexpression but it was not statistically significant(p>0.05). c-erbB2 positive patients showed shorter disease free survival compared to c-erbB2 negative patients in univariate analysis(p<0.05)(Kaplan Meire analysis). The patients without c-erbB2 overexpression seemed to survive longer but had no significant survival benefit(p>0.05). CONCLUSION: These findings suggest that overexpression of c-erbB2 may be a marker of poor response to adjuvant chemotherapy with CMF regimen and may be an indicator of more aggressive therapy.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Estrogens ; Fluorouracil ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Methotrexate ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone