Among various vascular interventional procedures, there are some procedures of vascular recanalization often encountered by primary physicians in clinical practice. These are percutaneous transluminal angioplasty (PTA) and stent application in the lower extremity ishemia, catheter-directed thrombolysis with PTA, stenting for iliofemoral deep vein thrombosis, and interventional management of arteriovenous fistula and graft for hemodialysis access. PTA and stent are safe and effective treatment for iliac arterial stenosis and occlusion with a good long-term patency rate. Long-term effectiveness of femoropopliteal stent is yet to be determined. Catheter-directed thrombolysis is a new emerging vascular intervention for acute iliofemoral deep vein thrombosis. May-Thurner syndrome can be effectively treated with thrombolysis in the iliofemoral vein followed by PTA ad stenting for the left iliac vein stenosis or occlusion. For the failing arteriovenous fistula or grafts in patients with hemodialysis, interventional radiologists can play an important role for the maintenance of the patency by percutaneous thrombolysis and balloon dilatation. It will be very helpful for the primary physicians to understand the role of the interventional radiologists and the indications, techniques, and results of those vascular interventional procedures often encountered in daily practice.
Angioplasty ; Arteriovenous Fistula ; Constriction, Pathologic ; Dilatation ; Humans ; Iliac Vein ; Lower Extremity ; May-Thurner Syndrome ; Renal Dialysis ; Stents ; Transplants ; Veins ; Venous Thrombosis

No abstract available.
Blood Vessel Prosthesis* ; Stents*

OBJECTIVE: To assess the potential clinical utility of in-vivo 31P magnetic resonance spectroscopy (MRS) in patients with various malignant and benign breast lesions. MATERIALS AND METHODS: Seventeen patients with untreated primary malignant breast lesions (group I), eight patients with untreated benign breast lesions (group II) and seven normal breasts (group III) were included in this study. In-vivo 31P MRS was performed using a 1.5 Tesla MR scanner. Because of the characteristics of the coil, the volume of the tumor had to exceed 12 cc (3 x 2 x 2 cm), with a superoinferior diameter at least 3 cm. Mean and standard deviations of each metabolite were calculated and metabolite ratios, such as PME/PCr, PDE/PCr, T-ATP/PCr and PCr/T-ATP were calculated and statistically analyzed. RESULTS: Significant differences in PME were noted between groups I and III (p=0.0213), and between groups II and III (p=0.0213). The metabolite ratios which showed significant differences were PME/PCr (between groups II and III) (p=0.0201), PDE/PCr (between groups I and III, and between groups II and III) (p=0.0172), T-ATP/PCr (between groups II and III) (p=0.0287), and PCr/T-ATP (between groups II and III) (p=0.0287). There were no significant parameters between groups I and II. CONCLUSION: In-vivo 31P MRS is not helpful for establishing a differential diagnosis between benign and malignant breast lesions, at least with relatively large lesions greater than 3 cm in one or more dimensions.
Adult ; Breast Neoplasms/*diagnosis/*metabolism ; Diagnosis, Differential ; Female ; Human ; Magnetic Resonance Spectroscopy/*methods ; Middle Age ; Phosphates/metabolism ; Tumor Markers, Biological/metabolism

The incidence of ectopic pregnancy is apparently increasing in recent years. In order to gain greater insight into the diagnosis and management of ectopic pregnancies, this study was undertaken on 100 patients with ectopic pregnancy(admitted via ER) who were operated and confirmed by histopathological study at the department of Obstetrics and Gynecology of Hallym University(Kangdong Sacred Heart Hospital) from January, 1996 to June, 1997. The results were as follows; 1. The hospital incidence of ectopic pregnancy was 1 in 11.6 deliveries(168/1954). 2. The most frequent age group was in 25-34 years of ages(58%). 3. Nullipara was 32 cases(32%) and number of cases who had 1, 2 and 3 deliveries were 35(35%), 31(31%) and 2(2%) respectively. 4. The most frequent number of pregnancy was second times(24%) and 65% of cases have been experienced artificial abortion. 5. In the past history, of possible predisposing factors, 65% had at least one abortion, 17% ectopic pregnancy, 17% cesarean section and 13% had previous laparoscopic tubal sterilization, but 19% showed no special distinct. 6. The main clinical symptoms are 96% in lower abdominal pain, 95% in amenorrhea and 65% in vaginal spotting and bleeding. 7. The most frequent interval between LMP and onset of symptoms was 6-8 weeks(49%). 8. Urine hcG test was positive in 94.9% and culdocentesis was positive in 94.3%. 9. In initial hemoglobin level, more than 11.0g% was 55%, however less than 10.0g% was 20%. 10. In initial systolic blood pressure at hospital, most of them were under normal condition, however 30% were under 90mmHg. 11. The amount of intraabdominal hemorrhage under 500cc was 42%(highest rate), 25% under 500cc-1000cc(second rate) and 6 cases overed 200cc. 12. The site of ectopic pregnancy was 88% in fallopian tube, 9% in uterine conus, 2% in intraabdomen and 1% in cervix. 13. The most common surgical procedure was ipsilateral salpingectomy(82%), of which 22 cases were operated by laparoscopy. 14. There was no fatal case in 100 ectopic pregnancy.
Abdominal Pain ; Amenorrhea ; Blood Pressure ; Causality ; Cervix Uteri ; Cesarean Section ; Conus Snail ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Fallopian Tubes ; Female ; Gynecology ; Heart ; Hemorrhage ; Humans ; Incidence ; Laparoscopy ; Metrorrhagia ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Sterilization, Tubal

To evaluate the influence of tourniquet ischemia and hyperthermia on the radiation effect of skin, theexperimental study was undertaken using a total of 344 mice. A single dose of irradiation from 2000 rads to 8000rads was delivered on skin of mouse tail after hyperthermia of 40degrees(C) to 42degrees(C) with or withouttourniquet application in various subgroups. The resuls are summarized as follows; 1. Tourniquet ischemia duringirradiation caused radioprotective effect. 2. Hyperthermia before irradiation induced radiosensitizing effect,which was increased with temperature elevation of hyperthermia. 3. In combination of tourniquet ischemia andhyperthermia, evident radiosensitizing effect waas noticed. This enhancing effect on irradiation was greater thanthe effect i hyperthermia only. It could be suggested that the combination of tourniquet application andhyperthermia might be intorduced in clinical radiotherapy after trail of clinical experiments on applicable typeand sutiable location of tumors.
Animals ; Fever ; Ischemia ; Mice ; Radiation Effects ; Radiation-Sensitizing Agents ; Radiotherapy ; Skin ; Tail ; Tourniquets

BACKGROUND: Infiltration of the skin and subcutaneous tissue with local anesthetic solutions may cause transient pain and discomfort. Heating local anesthetic solutions to body temperature has been suggested as a way of reducing the pain associated with injection. We designed a double blind crossover volunteer study to investigate the effect of warming lidocaine on the pain associated with subcutaneous injection. METHODS: Participants were 40 healthy adult volunteers,22 years of age and older, and they were the medical, nursing stay and medical students. They underwent 1ml subcutaneous injections of the study agent through 25-gauge needles. Following a standard crossover protocol, 'room temperature' lidocaine(20degrees C ) was injected into one midvolar forearm and body temperature' lidocaine(37degrees C ) into the opposite arm. Pain assessed by visual analogue pain scores and 'volunteer's comparison of pain on injection. RESULTS: Twenty-six volunteers thought that lidocaine at 20degrees C was more painful and four thought that lidocaine at 37degrees C was more painful, ten volunteers did not express a difference. Median pain score for injection at 20 degrees C was 37 and at 37 degrees C was 35.5. Difference of two median scores was 6.5. CONCLUSION: The simple procedure of warming to body temperature reduced the pain associated with subcutaneous injection of lidocaine. It is an inexpensive and practical method That should be considered for routine use in the ED.
Adult ; Arm ; Body Temperature* ; Forearm ; Heating ; Hot Temperature ; Humans ; Injections, Subcutaneous ; Lidocaine ; Needles ; Nursing ; Skin ; Students, Medical ; Subcutaneous Tissue ; Volunteers

No abstract available.
Skin, Artificial*

No abstract available.
Hysterectomy* ; Urinary Bladder*

PURPOSE: To evaluate the role of antegrade balloon dilatation and uteteral stenting in benign ureteral strictures. METHODS AND MATERIALS: Percutaneous antegrade balloon dilatation was attempted in 46 patients with benign ureteral strictures. The underlying causes of the strictures were urinary tract tuberculosis in 20 patients, congenital ureteropelvic junction obstruction in eight, ureteroneocystostomy or ureteroileostomy state in five, postoperative or post-extracorporeal shock wave lithotripsy state for ureteral calculi in eight, ureteral injury during surgery in four, and retroperitoneal fibrosis in one. RESULTS: Antegrade balloon dilatation was performed with initial technical success in 43 patients but the procedure was aborted in the remaining three with urinary tract tuberculosis due to the failure in passing a guidewire through the stenotic lesions. Intravenous urograms obtained 4-76 months after the procedure showed improvements in 76%(13/17) with urinary tract tuberculosis, in 63%(5/8) with congenital ureteropelvic junction obstruction, in 88%(7/8) with strictures associated with ureteral calculi, and in 100%(4/4) with iatrogenic ureteral injury. The results were relatively poor in strictures of the ureteral anastomosis(1/5) and in ureteralstrictures associated with retroperitoneal fibrosis(0/1). CONCLUSION: Antegrade balloon dilatation of the urinary tract combined with ureteral stenting was an effective technique for the management of the benign ureteral strictures.
Constriction, Pathologic* ; Dilatation* ; Humans ; Lithotripsy ; Retroperitoneal Fibrosis ; Shock ; Stents* ; Tuberculosis ; Ureter* ; Ureteral Calculi ; Urinary Tract

PURPOSE: To diagnose the coronary artery disease, it is necessary to have a thorough knowledge on coronary anatomy and normal variations. We performed a morphological study on normal variations of coronary artery in Korean adults. MATERIALS AND METHODS: 1012 cases of coronary angiography were analyzed with particular emphasis on the normal variation of three coronary arteries and their major branches, including origin of conus artery, sinus node artery and atrioventricular node artery and the variation in posterior descending artery and ramus medianus. RESULTS: We found right dominance in 895 cases(88.4%), left domainance in 44 cases(4.3%), and balanced dominance in 73 cases(7.2%). Conus artery branched from right coronary artery in 468 cases(47.6%) and originated in right coronary sinus close to the os of right coronary artery in 515 cases(52.4%). Sinus node artery originated from left circumflex artery in 551 cases(54.4%), from right coronary artery in 442 cases(43.7%), and from both coronary arteries in 19 cases(1.9%). Atrioventricular node artery originated from right coronary artery in 943 cases(93.4%), from left circumflex artery in 59 cases(5.8%), and two atriovenricular node arteries from both arteries in 8 cases(0.8%). Posterior descending artery had the normal pattern in 505 cases(58.6%) and some variation in 357 cases(41.4%). We found short left main coronary artery, less than 2--3 mm, making it hard to cannulate in 172 cases(17.0%). Ramus medianus was found in 165 cases(16.5%) with marginal distribution in 84 cases(8.4%), diagonal distribution in 80 cases(8.0%) and coursing interventricular sulcus as double left anterior descending artery in 1 case(0.1%). Left main coronary artery gave off 4 branches in 8 cases(0.8%). Myocardial bridging was found in only 3 cases(0.3%). CONCLUSION: This study could provide basic morphological data on anatomy and normal variations of coronary arteries in Korean adults.
Adult ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Sinus ; Coronary Vessels* ; Humans ; Myocardial Bridging