PURPOSE: To assess the effects and complications of balloon dilatation in the treatment of postoperative stricture at the gastrointestinal tract. MATERIALS AND METHODS: From February 1991 to July 1993, balloon dilatation was performed under fluoroscopic guidance on 5 patients (age:l month to 64 yrs, male:female=2:3) who previously had undergone abdominal surgery because of stomach cancer (n=2), congenital tracheoesophageal fistula (n=l), lye stricture (n=l), and colon cancer (n=l). Causes of the stricture were all benign (n=4) except for one (recurrence of malignant tumor). We dilatated the stricture site with balloon catheter (8--25 mm in diameter) 3 to 4 times per session which was repeated 1 to 5 times in each patient. Follow-up periods ranged 8 to 15 months after the treatment. RESULTS: Two out of four benign strictures were relieved at one session, and the remaining two needed repeated sessions of balloon dilatation. Symptoms did not improve in the patient with malignant stricture in~pite of balloon dilatation, and feeding jejunostomy was reginred. Partial tear of anastomosis site occurred in one patient, however, it did not require any treatment. CONCLUSION: Balloon dilatation is relatively safe and effective in the treatment of postoperative stricture at the gastrointestinal tract.
Catheters ; Colonic Neoplasms ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Gastrointestinal Tract* ; Humans ; Jejunostomy ; Lye ; Stomach Neoplasms ; Tracheoesophageal Fistula

No abstract available.
Pulmonary Atelectasis*

Maintenance of well-functioning arteriovenous graft through interventional management is critical in the patients undergoing repeated, scheduled hemodialysis due to chronic renal failure (CRF). Understanding basics and procedures of intervention applied is critical to the people working in medical fields to adequately manage the patients. The author expects that through understanding interventional procedures, people working in this field adequately manage the patients undergoing hemodialysis due to CRF by well prepared medical aids.
Fistula ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Transplants

PURPOSE: The purpose of this study is to determine the detection rate of early gastric cancer and to measure the focal gastric wall thickening in computed tomography. MATERIALS AND METHODS: From November 1991 to November 1993, 19 patients (age;33--76 years, male ;female:4;5) with surgically proven early gastric cancer were examined by upper gastrointestinal series and abdominal computed tomography. Twenty lesions in these patients were included in this study. Computed tomography was performed with conventional technique using gastrografinR (17 cases) or water filling (2 cases) method in supine position. Additional scans were obtained either in right down decubitus (15 cases) or supine position (4 cases) with an ingestion of gas forming agent. We determined the detection rate of early gastric cancer at computed tomography and measured the maximum thickness of the lesion. RESULTS: The pathologic types of the early gastric cancer were type lib + IIc in 5 cases, type IIc in 6, type III in 3 and type I, I + IIc, Ila, lib, lib + III and IIc + III in one, respectively. Seventy-five percent (15 cases) of early gastric cancer was detected at upper gastrointestinal series and fifty percent (10 cases) at computed tomography. Computed tomography could detect 100% of elevated carcinomas (3/3) and 41% of depressed carcinomas (7/17). The maximum thickness of the lesion ranged from 7 mm to 11 mm (mean ;8mm). CONCLUSION: In a well-distended stomach, CT could detect focal gastric wall thickening (mostly, less than 1 cm) caused by early gastric cancer in half of the cases.
Eating ; Humans ; Male ; Stomach ; Stomach Neoplasms* ; Supine Position ; Water

Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

40 cases of bile duct carcinoma gathered over a 6-year period at Kosin Medical College were reviewed and theirclinical and cholangiographic findings were as follows: 1. There were 29 males and 11 females (the ratio of men towomen, 2.6:1) ranging from 37 to 74 years of age. The majority (70% of cases) were in 4th & 5th decades. 2.Clinical symptoms and signs: jaundice in 95%, RUQ or epigastric pain in 75%, pruritus in 52.5%, dark urine in 35%,weight loss in 32.5%, fever and chills in 22.5%, clay colored stool in 12.5%, and palpable mass in 12.5%. 3.Lab,findings: elevated serum total bilirubin(above 20.0mg% in 45%, 10.0-19.0mg% in 22.5%, 5.0-9.9mg% in 20%,1.3-4,9mg% in 5%), elevated alkaline phosphatase in 95%. Clonorchiasis were noted in 17.5%. 4. Histologic findingswere adenocarcinoma in most cases. 5. The location of bile duct carcinoma were common hepatic duct in 35%, commonbile duct in 32.5%, porta hepatis in 12.5%, junction with cystic duct in 10% and diffuse form in 10%. 6. In 33cases, PTC or post-operative cholangiographic examination were done. And the most frequent findings weredilatation of the proximal bile duct and abrupt narrowing or complete obstruction of distal lumen. In 27cases(82%), complete obstruction of bile duct was noted. Attempts were made to analyze the type of obstruction:Constricted type in 39%, Nipple type in 18%, round or flat type (smooth or slightly irregular) in 15%, andserratd type in 9%. Incomplete obstruction were noted in 6 cases(18%). Among them, abrupt narrowing of lumen wasnoted in 9% and diffuse narrowing in 9%. 7. ERCP was done in 7 cases. Findings were constricted type in 42.6%,constricted and slightly irregular type in 14.3%, downward convexity in 14.3%, diffuse irregular narrowing in14.3% and intraluminal filling defect in 14.3%.
Adenocarcinoma ; Alkaline Phosphatase ; Bile Ducts ; Bile ; Chills ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis ; Cystic Duct ; Female ; Fever ; Hepatic Duct, Common ; Humans ; Jaundice ; Male ; Nipples ; Pruritus

No abstract available.
Carcinoma, Hepatocellular* ; Diagnosis*

PURPOSE: To evaluate the severity of tissue necrosis of liver according to various kinds of contrast materials used in percutaneous transhepatic procedure. MATERIALS AND METHODS: Four kinds of commercially available contrast material were used in the this study :meglumine ioxithalamate (ionic monomer, Telebrix 30, Guerbet, France), meglumine ioglicinate (ionic dimer, Rayvist 300, Schering, Germany), iopromide (nonionic monomer, Ultravist 300, Schering, Germany), and iotrolan (nonionic dimer, Isovist 300, Schering, Germany). The same amount(0.1 ml) of each contrast material was directly injected into the liver of Sprongue-Dawley rats. After two days and four weeks, the histopathologic findings of resected liver were assessed and analysed with special emphasis on the difference in the area of tissue necrosis between each group. RESULTS: In the liver resected 48 hours later, the area of necrosis was related to the osmolality and ionicity of contrast material used :the higher the osmolality, the wider the area of necrosis and ionic contrast material exhibited wider area of necrosis than nonionic contrast material. In the liver resected four weeks later, almost complete recovery was seen at the site of necrosis in all groups. CONCLUSION: Nonionic contrast materials caused less tissue necrosis than ionic contrast materials in percutaneous transhepatic procedure because of their lower osmolality.
Animals ; Contrast Media* ; Liver* ; Meglumine ; Necrosis ; Osmolar Concentration ; Rats*

No abstract available.
Diagnosis, Differential*

Neurofibromatosis, or von Recklinghausen's disease, is a hereditary, harmartomatous disorder that primarilyinvolves neuroectoderm and mesoderm. The estimated incidence is 1 in 2,500 to 3,000 births. The clinical featuresare skin manifestations such as cafe-au-lait spots, skeletal manifestations primarily in volving vertebrae,central and peripheral nervous manifestations, and other associated abnormalities with increased risk ofmalignancy. The authors analysed the radiologic findings of 18 cases of patients with neurofibromatosis whovisited Pusan Kosin Medical Center and Taegu Dongsan Medical Center during the last five years. All were proven bysurgery, biopsy and other diagnostic criteria. The results obtained were as follows: 1. The male ot female ratiowas 11:7 and the age ranged from 11 months to 51 years. 2. All the cases fulfilled the diagnotic criteria of Croweand associates. 3. Bone manifestations were present in 44% of the cases. The other radiologic findings wereintrathoracic meningocele, bilateral acoustic neurinomas, mediastinal or chest wall mass shadows, and peripheralsoft tissue masses. 4. One of the soft tissue masses was proved to be malignant.
Biopsy ; Busan ; Cafe-au-Lait Spots ; Daegu ; Female ; Humans ; Incidence ; Male ; Meningocele ; Mesoderm ; Neural Plate ; Neurofibromatoses ; Neurofibromatosis 1 ; Neurofibromatosis 2 ; Parturition ; Skin Manifestations ; Thoracic Wall