No abstract available.
Breast* ; Carcinoembryonic Antigen* ; Humans ; Stomach*

No abstract available.
Stomach Neoplasms*

No abstract available.

No abstract available.
Acute Kidney Injury*

PURPOSE: Inidence of recurrent common duct stones reported approximately 20% for a second operation, and with even higher rate following subsequent reoperation. However, the factors contributing to recurrent stones have not well defined. Some authors have reported on association of juxtapapillary diverticula with recurrent biliary stones. We have studied to assess the clinical significance of coexisting PAD on recurrent common bile duct stones and to establish the rational operative procedure in primary or recurrent common duct stones with coexisting PAD. METHODS: Medical records of 456 consecutive patients (Feb. 1993~Aug. 2002) who performed ERCP for biliary symptoms were reviewed. We comparative study retrospectively have done between patients with and without PAD on recurrence of common duct stones and outcome of treatment. RESULTS: Incidence of PAD was 15.1% on ERCP, and increased in the old aged patients. Incidence of biliary stone in PAD group was higher than that of non-PAD group (73.9% vs. 50.6%), and gall stone involving common duct was more prevalent in PAD group than non-PAD group. PAD group showed higher stone recurrence rate (23.5% vs. 6.1%) and earlier recurrence following conventional treatment, and needs more multiple treatments, compared with non-PAD group. Intradiverticular papillae (IDP) type showed higher stone recurrence, compared with juxtapapillary diverticula (JPD) type (36.8% vs. 15.6%). CONCLUSION: PAD would be one of important contributing factors for development and recurrence of common bile ductstones. So rational operative procedure for primary or recurrent common duct stones with coexisting PAD should include extirpation of PAD, particulary in IDP type.
Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Medical Records ; Recurrence ; Reoperation ; Retrospective Studies ; Surgical Procedures, Operative

No abstract available.
Balloon Valvuloplasty* ; Pulmonary Valve Stenosis* ; Pulmonary Valve*

BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
Angiography ; Angioplasty* ; Aortic Valve Insufficiency ; Cardiac Output, Low ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Pericardium ; Postoperative Complications ; Retrospective Studies ; Spasm

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*

No abstract available.
Humans ; Stomach Neoplasms*

BACKGROUND: Diagnosis of aortic arch obstruction can be made with two-dimensional and Doppler echocardiography in most cases.However,not infrequently,clear imaging of the aortic arch can not be obtained,particularly in sick neonates and young infants from a number of reasons and heart catheterization and angiography carries significant risk in sick babies.Therefore it is the purpose of this study to assess the feasibility and safety of counter-current aortography through a peripheral artery in young infants and neotates with suspected aortic arch obstruction. METHOD: We studied 56 patients with suspected aortic arch anomaly at Asian Medical Center from Feburary 1990 to April 1997.First choice for the peripheral artery was radial artery on the same side as the aortic arch,followed by brachial artery and axillary artery.Small 24 gauge plastic cannula was inserted and special attention was given to ensure that the peripheral artery,plastic cannula,and a syringe containing contrast material are all in the same plane.1ml/kg of contrast material was injected by rapid hand injection and biplane cineangiograms were taken at 60 frame/second. RESULTS: Fifty six patients underwent 58 angiograms.Age ranged from 5-255 days(median 30 days) and body weight nanged from 2.1-5.4kg(mean3.4kg).There were 27 males and 29 females.Arteries used were:Radial artery in 37,brachal artery in 19,and axillary artery in 2 cases.Peripheral arteries were ipsilateral side as the aortic arch in 54,contralateral side in 2 and bilateral in 2 cases.In 8 patients heart catheterization was done because of inadequate visualization of aortic arch anatomy and/or need for evaluating other defects.In 48 patients who had periperal angiography only,fluoroscopic time ranged from 0.6 to 3.5 minutes and total procedure time ranged from 10 to 15 minutes.Among these 48 patients,only 11 patients(23%) were given intraveous sedation and 37 patients(77%) did not recieve any sedation.Diagnosis of aortic arch anomaly was aortic coarctation in 38,aortic interruption in 10 and nomal aortic arch in 8 patients.Aortic arch anatomy was well demonstrated in all cases where injected artery was on the same side as the aortic arch.In patients who had angiograms through peripheral arteries contralateral to the side of the aortic arch did not haveadequate visualization of the arch.Compression of the carotid artery did not enhance the imaging of the arch.Simultanous bilateral angiography did not improve the imaging quality as compared to ipsilateral artery angiography.Transient complication,related to cannulation,e.g.,prolonged bleeding was seen in only one patient with aortic interruption.Circulation on the upper extremities was normal after angiography in all patients. CONCLUSION: Counter-current aortography using 24 gauge plastic cannular through peripheral artery is feasible,rapid,safe,economic and relatevely non-invasive procedure and provides adquate imaging of aortic arch obstruction in infants and neonates without risk of heart catheterization and angiography.We,therefore,recommend this procedure in selected patients in whom echocardiographic imaging alone is not conclusive for planning corrective sursery.
Angiography ; Aorta, Thoracic* ; Aortic Coarctation ; Aortography* ; Arteries* ; Asian Continental Ancestry Group ; Axillary Artery ; Body Weight ; Brachial Artery ; Cardiac Catheterization ; Cardiac Catheters ; Carotid Arteries ; Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Hand ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn* ; Male ; Plastics ; Radial Artery ; Syringes ; Upper Extremity