No abstract available.
Scrub Typhus*

A fistulous comunication between kidney and colon after trauma is rare and usually causes severe damage to kidney necessitating nephrectomy. Intrarenal aneruysm after trauma is also rare and its accurate diagnosis is important. Authors have experienced a reno-colic fistula and intrarenal aneruysm occured in a same patient afterpenetrating renal injury.
Aneurysm ; Colon ; Diagnosis ; Fistula ; Humans ; Kidney ; Nephrectomy

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

No abstract available.
Acute Kidney Injury ; Mannitol* ; Renal Insufficiency*

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

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Hospitals, General* ; Humans

No abstract available.
Hepatitis B Surface Antigens* ; Hospitals, General*

PURPOSE: To assess the usefulness of the ultrasound-guided subclavian vein catheterization in difficult patients. MATERIALS AND METHODS: We tried subclavian vein catheterization in 18 patients in which conventional blind technique failed(N=9) :or was complicated by hemothorax or pneumothorax(N=3) :or was prohibited by respirator care(N=4) and severe thoracic deformity(N=2). Initially, the patency of subclavian vein was evaluated with ultrasonography, and then, the puncture of the subclavian vein was performed under the guidance of ultrasonography. Under the fluoroscopy, the patency of the proximal subclavian vein and the superior vena cava was evaluated after contrast-media injection and a catheter was inserted into the subclavian vein and accurately positioned at the superior vena cava. RESULTS: Successful catheterization was performed in 17 patients. In the remaining one patient, we did not perform catheterization because of bilateral subclavian vein thrombosis detected during the procedure. There were no procedure-related complications. CONCLUSION: Ultrasound-guided subclavian vein catheterization is an easy and safe method even in difficult cases.
Catheterization* ; Catheters* ; Fluoroscopy ; Hemothorax ; Humans ; Punctures ; Subclavian Vein* ; Thrombosis ; Ultrasonography ; Vena Cava, Superior ; Ventilators, Mechanical