No abstract available.
Humans ; Prostate* ; Urinary Retention*

No abstract available.
Seoul*

A 41-year-old female was admitted to our hospital for self-audible wheezing sound and dyspnea. On past history, she has been suffered from chest discomfort, and treated recurrently by other hospitals. But, there was no symptomatic improvement. A stridor and mixed wheezing sound was auscultated on whole lung field. PFT revealed fixed type or variable intra- & extra-thoracic air way obstructive pattern. By bronchoscopy & bronchogram, we found web-like structure on the distal trachea. A bronchoplasty was performed and the post-operative PFT showed slight improvement & she had no more complaints.
Adult ; Bronchoscopy ; Dyspnea ; Female ; Hemoptysis* ; Humans ; Lung ; Respiratory Sounds ; Thorax ; Trachea

The provocation test of variant angina are known as ergonovine test, hyperventilation, acetylcholine, exercise and cold pressor test, but beta-blocker provocation test has not been reported as a case. So, this paper reports on the diagnosis of variant angina by beta-blocker provocation test and the case of subendocardial infarcion induced by this test. This study reports with literature and investigation about the following case : A 45-year-old man with a history of recurrent episode of typical angina on the early morning for the past 20 days. He was administrated beta-blocker given by oral route, and on the next morning there was chest pain as same degree as before, Holter EKG displayed ST segment elevation and ventricular tachycardia. It was confirmed focal spasm on coronary angiography, ST segment elevation on EKG, and newly developed hypokinesia on left ventriculogram and followed-up echocardiagraphy. When the chest pain is absent, EGK was normal. And we confirmed that elevation of cardiac enzyme was absent as a result of serial follow up study.
Acetylcholine ; Chest Pain ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Hyperventilation ; Hypokinesia ; Infarction* ; Middle Aged ; Spasm ; Tachycardia, Ventricular

PURPOSE: Percutaneous Transhepatic Cholangioscopic Lithotomy (PTCS-L) has been reported as an effective and safe therapeutic method for complicated hepatobiliary stones, particularly in high risk patients. However, there were some limitations and technical difficulties encountered in PTCS-L. The purpose of this retrospective study was to assess the result of PTCS-L in patients with recurrent or residual hepatobiliary stones. METHODS: The medical records of 61 consecutive patients (Jan.1997~Jun.2002) treated with PTCS-L for biliary stone were reviewed. There were 29 patients with primary treatment, and 32 patients with adjuvant treatment for residual stones. PTCS-L was performed within 2 weeks following progressive exchange of PTCS catheter after PTBD. Lithotomy was combined with either electrohydraulic lithotripsy (EHL), Dormia basket, or saline irrigation under fluroscopic guide. If stone was free on one or two consecutive cholangiography after final session lithotomy, then PTCS catheter was removed, but in cases of biliary stricture, 20Fr. of PTCS catheter was placed for average 71 (ranged; 27~270) days. RESULTS: Locations of stones were intrahepatic duct (IHD) in 22 cases, common bile duct (CBD) in 22 cases, CBD & IHD in 11 cases, cystic duct stump & CBD in 3 cases, GB in 2 cases and GB & CBD in 1 case. Routes for PTCS-L were of Rt. hepatic approach (B5 or B6) in 15 cases, Lt. hepatic approach (B3) in 42 cases, both hepatic approach in 2 cases and percutaneous gallbladder drainage (PGBD) tract in 2 cases. Sessions of PTCS-L were one in 22 cases, two in 26 cases, three in 9 cases and four in 4 cases, and overall in 1.5 session. Causes of multiple session in 39 cases were biliary stricture in 13 cases (33%), impacted stones in 10 cases (26%), large stone (>2 cm) in 9 cases (23%) and anatomical variation of IHD including severe ductal angulation in 7 cases (18%), which necessitated routine combined use of EHL (total 44 cases) and sometimes fluroscopic lithotomy (3 cases). Complications encountered following PTCS-L were transient hemobilia in 11 cases, catheter dislodgement in 1 case and hepatic abscess in 1 case, but mortality was nil. During followed up of median 17 months (1~53 months), recurrence of stone occurred in 1 case and one among of 13 patients with biliary stricture underwent operation on recurred biliary stricture. CONCLUSION: PTCS-L is very useful alternative treatment to surgery for residual or recurrent stones and is highly indicated for those of high risk patients. However, Electrohydraulic lithotripsy (EHL) should be combined for those of patients with technical difficulties encountered in case of multiple large impacted stones particularly in the strictured and angulated intrahepatic ducts.
Catheters ; Cholangiography ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Drainage ; Gallbladder ; Hemobilia ; Humans ; Lithotripsy ; Liver Abscess ; Medical Records ; Mortality ; Recurrence ; Retrospective Studies

For the past two years, nephropexy using PCN was underwent in 9 cases of nephroptosis (8 patients) with variable degrees of flank pain. All were female and 6 on right, 1 on left and 1 on bilateral. All patients had a very mobile kidney and exact distance of movement measured on the film was greater than 6cm (6 to 15 cm). After this operation, 14-20 Fr. nephrostomy catheter was indwelled for about two weeks. All patients were followed at least 3 months(3 to 32, median 17 months). We followed the patients with symptom relief and IVP after 3 months. Nephropexy was regarded as success if she remained asymptomatic for more than 3 months. Five cases were successful and four cases felt recurrent flank pain within 1 month after the surgery. Among four cases of recurrence, one had repeated PCN and got successful result, another had open nephropexy and the others have been followed so far So overall success rate was 67% (6/9). In conclusion, nephropexy using PCN is less invasive, needs shorter period of admission and leaves ignorable scars postoperatively. Furthermore it can be repeated even in the case of failure or recurrence, which would make this new technique available as the first step for the surgical treatment of nephroptosis. And the success rate could be increased if the nephrostomy tract is dilated upto 30 Fr. and the PCN catheter is placed about 4 weeks.
Catheters ; Cicatrix ; Female ; Flank Pain ; Humans ; Kidney ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Recurrence

PURPOSE: The purpose of this study was to compare the efficacy of dexpanthenol in postoperative patients. Dexpanthenol, the alcohol derivative of pantothenic acid, is believed to be a precursor of acetylcholine through its incorporation into coenzyme-A. METHODS: From June 2005 to December 2005, 130 curative abdominal surgery, which were divided into a dexpanthenol group with 65 patients and a control group with 65 patients, were prospectively and randomly studied for recovery of bowel motility. RESULTS: No significant difference was found between the two groups as to incidence of postoperative ileus (16.9% vs. 15.4%, P=0.081), the time to flatus (77.2+/-38.4 vs. 77.9+/-31.9 hours, P=0.90), the time to defecation (5.3+/-2.7 vs. 5.1+/-2.6 days, P=0.77), the time to resumption of meals (7.9+/-4.0 vs. 8.9+/-4.2 days, P=0.17), and the duration of hospital stay (16.4+/-7.8 vs. 17.9+/-11.5 days, P=0.39). CONSLUSIONS: Since no differences in the postoperative bowel motility were observed between the two groups, dexpanthenol is not recommended for general surgical use.
Acetylcholine ; Defecation ; Flatulence ; Humans ; Ileus ; Incidence ; Length of Stay ; Meals ; Pantothenic Acid ; Prospective Studies

We report the vesicouterine fistula due to migration of intrauterine device in 35-year-old woman, who had suffered from dysuria and watery vaginal discharge for 4 months. The vesicouterine fistula was confirmed by ultrasonography, cystoscopy and fistulography, and treated with laparoscopic fistulectomy.
Adult ; Cystoscopy ; Dysuria ; Female ; Fistula* ; Humans ; Intrauterine Devices* ; Ultrasonography ; Vaginal Discharge

PURPOSE: The clinical significance of preoperative serum levels of tumor markers CEA and CA19-9 was evaluated in gastric cancer patients. METHODS: Serum levels of CEA and CA19-9 were measured in 1, 310 patients with gastric cancer who underwent laparotomies over a recent 10-year period (1992~2001). The correlations between the serum levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factor was assessed by multivariate analysis. RESULTS: The positivity rates of CEA and CA19-9 were 17.5% and 13.4%, respectively. The positivity rate of CEA was higher in the elderly, in male patients, and in those with histologically differentiated tumors, whereas CA19-9 positivity was related to tumor location. In addition, the positivity rates of each tumor marker were significantly correlated with tumor size, gross type, depth of invasion, lymph node metastasis, peritoneal and liver metastases, and cancer stage. A significant difference in survival was observed between patients positive and negative for CEA and CA19-9. The multivariate analysis showed that in addition to gross type, depth of invasion, lymph node metastasis, peritoneal and liver metastasis, preoperative serum CEA and CA19-9 levels among those undergoing However, multivariate analysis of curatively resected cases identified gross type, depth of invasion, lymph node metastasis, and CA19-9 as significant prognostic variables. CONCLUSION: Preoperative serum CEA and CA19-9 determination in patients with gastric cancer is of value for the prediction of tumor progression and prognosis. However, serum CA19-9 level was more useful than CEA as a1 prognostic factor in patients undergoing curative resection.
Aged ; Biomarkers, Tumor ; Carcinoembryonic Antigen ; Humans ; Laparotomy ; Liver ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms*

Nalbuphine, a mixed agonist-antagonist type opioid, can precipitate abstinence syndrome in opioid-dependent patients especially in large doses. We can prevent this syndrome by avoiding the injection of agonist-antagonist type opioid to the patient who already has used opioid for a long time, and the method of relatively small dose increments in its use. We experienced a case of opioid withdrawal symptom in chronically morphine-administered patient via epidural catheter after using intramuscular nalbuphine for analgesia. The symptom was promptly relieved by intravascular morphine injection without any problems.
Analgesia ; Catheters ; Humans ; Morphine ; Nalbuphine* ; Substance Withdrawal Syndrome*