No abstract available.
Biomarkers* ; Child* ; Hepatitis B* ; Hepatitis* ; Humans ; Prevalence*

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

PURPOSE: The purpose of this study was to describe the anglographic finding and clinical result of transarterial embolotherapy(TAE) in patients with injuries of renal artery branches by blunt trauma. MATERIALS AND METHODS: The study was based on retrospective analysis of seven cases, in which TAE was attempted for the control of traumatic renal arterial bleeding. All procedures were performed via the transfemoral approach. TAE was performed with stainless steel coil in two cases, Gelfoam in one case, and Gelfoam and stainless steel coil in four cases. RESULTS: Angiographic findings of vascular injuries were pseudoaneurysm in four cases, extravasation in two cases and arteriocalyceal fistula in one case. All procedures were performed successfully without complication. CONCLUSION: Pseudoaneurysm is a common anglographic finding in patients with injury of renal artery branches and TAE is considered a safe and effective method for treating such cases.
Aneurysm, False ; Embolization, Therapeutic* ; Fistula ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Renal Artery* ; Retrospective Studies ; Stainless Steel ; Vascular System Injuries

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

We report two cases of cellulitis on the saphenous venectomy scar which developed after a coronary artery bypass graft(CABG). A 68-year-old male and a 62-year-old female developed acute cellulitis in the saphenous vein donor extremity after CABG. The repeated bacterial cultures were negative in both cases. However, onychomycosis was confirmed in one patient. The intervals between CABG and the initial bout of cellulitis in the male and female patient were 10 and 22 months, respectively. Although the exact pathogenesis remains obscure, factors such as direct bacterial infection, hypersensitivity to streptococcal exotoxins, a local compromise of lymphatic and venous drainage, and fungal infection might have contributed to the development of cellulitis in these patients.
Aged ; Bacterial Infections ; Cellulitis* ; Cicatrix* ; Coronary Artery Bypass* ; Coronary Vessels* ; Drainage ; Exotoxins ; Extremities ; Female ; Humans ; Hypersensitivity ; Male ; Middle Aged ; Onychomycosis ; Saphenous Vein ; Tissue Donors

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

No abstract available.
Granuloma Annulare* ; Granuloma* ; Herpes Zoster*

A retrospective analysis was done on 68 patients with primary superficial bladder cancer between September 1989 and December 1995. We evaluated the predictive value of urine cytology in the recurrence and the progression of superficial bladder cancer. Positive cytology was shown in 52.9% (36/68) and was significantly associated with tumor grade (p=0.001). The recurrence rate in patients with negative cytology was 28.1% (9/32) compared to 77.8% (28/36) in those with positive cytology (p=0;001). No patients of negative cytology had tumor progression while 4 out of 36 (11.1%) patients of positive cytology had progression to invasive or metastatic disease. In conclusion, urinary cytology appears to be a significant prognostic factor in superficial bladder cancer.
Humans ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*