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

PURPOSE: We studied to evaluate the effect of percutaneous catheter drainage (PCD) in liver abscess. MATERIALS AND METHODS: We retrospectively analyzed clinical data (presence of fever, WBC count), radiological findings (computed tomography, ultrasonography and abscessogram) and correlated them with treatment period. Percutaneous drainage of liver abscess were performed in 19 patients under fluoroscopy guide during recent three years. RESULTS: Eighteen patients (95%) were cured, and one patient underwent surgery because of peritonitis caused by PCD procedure. Average treatment period was 17 days. CONCLUSION: In the treatment of liver abscess, PCD is thought to be safe and effective.
Catheters* ; Drainage* ; Fever ; Fluoroscopy ; Humans ; Liver Abscess* ; Liver* ; Peritonitis ; Retrospective Studies ; Ultrasonography

Successful block of the celiac plexus denervates the denervatives of the foregut and therefore can successfully interrupt nociceptive stimuli from the pancreas, stomach, liver, etc. Although permanent neurolytic block is much less successful for malignant chronic pancreatitis syndrome, it is specifically useful for treatment of intractable pain that often accompanies carcinoma of the pancreas or other upper abdominal visceral tumors. This was a case report in which intractable pain due to malignant gastric cancer was successfuly controlled by the permanent neurolytic celiac plexus block.
Celiac Plexus ; Liver ; Pain, Intractable ; Pancreas ; Pancreatitis, Chronic ; Stomach ; Stomach Neoplasms*

Many studies have shown that epidural narcotics produce prolonged analgesic action. We instillated 2mg of morphine on the dura just before wound closure which was exposed for lumbar laminectomy. Sixty patients scheduled for laminectomy were devided into two groups i.e., morphine group (30 patients) and control group(30 patients). The results of this study were as follows: 1) In morphine group, 17 patients (56.6%) tolerated the postoperative pain without narcotic injection for over 20 hours, but 13 patients(43.3%) of the control group required narcotic injection within 5 hours. 2) Severe respiratory depression was noted in two cases from the morphine group. 3) It is a very simple and effective method for postoperative pain control.
Humans ; Laminectomy ; Morphine* ; Narcotics ; Pain, Postoperative* ; Respiratory Insufficiency ; Wounds and Injuries

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

Percutaneous catheter drainage (PCD) of pancreatic pseudocyst has been reported to have good therapeutic results, low complications, and short hospital course. To find the clinical and radiological findings which can predict the treatment period for PCD, we retrospectively correlated the clinical data (presence of invection, initial and 1 week follow-up serum and aspirate amylase level, daily drainage amount) and radiological findings (evidence of fistula, PCD route, inital size of pseudocyst) with the treatment period in each case. The age ranged from 20 to 64 years(mean:39.8 years) and male to female ratio was nine to one. When the cavity was obliterated after PCD and did not recur after tube removal without a surgical treatment, we regarded the patient to be cured. Mean treatment period was 20.2 days and nine patients(90%) were cured. We think that the factors shortening treatment period are the presence of superimposed infection and the abrupt decrease of the amount of daily drainage for the first week. But the presence of fistula to the pancreatic duct may prolong the treatment period. In conclusion, PCD is safe and effective in the treatment of pancreatic pseudocyst, and the clinical ad radiological findings are expected to be able to predict the treatment period of PCD.
Amylases ; Catheters* ; Drainage* ; Female ; Fistula ; Follow-Up Studies ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Retrospective Studies

BACKGROUND: Tuberculous cervical lymphadenitis is a granlomatous lymphadenitis which is the most common extra-plumonary tuberculosis in Korea. There are several controversies about the methods and the duration for the treatment of the disease. METHODS: We have studied 208 cases of tuberculous cervical lymphadenitis which were treated at Chung-Goo Sung-Shim Hospital from January 1992 to December 1996. RESULTS: The result of the study are as follows: The most prevalent age group was the third decade followed by the fourth decade. For the sexual distribution, females predominated over males by 1.9 to 1. the unilateral location was the most common one (76.2%). The most frequent lesion was on the anterior cervical triangle (28.6%) Simple excision was performed in 194 cases and incision plus drainage in 14 cases. Antituberculous medication was applied to the patients in two different groups. Isoniazid, Rifampin and Ethambutol were administered every day to the patients in one of the groups. To the other group, Pyrazinamide was additionally administered - Isoniazid, Rifampin, Ethambutol, and Pyrazinamide were administered every day. The average duration of medication for the former group was 13 months, and that for the latter group was 11 months. We experienced 17 cases of recurrence in both groups. The recurrence rate was 3.7% (4 cases) for the group with Pyrazinamide included and 13.0% (13 cases) for the other. For the patients with recurrence who were treated with the pyrazinamide, extending the medication from 6 to 12 months brought about a complete treatment for all cases. However, for the cases of recurrence in the other group, in which Pyrazinamide were not applied, only 8 cases were treated completely by 12 months after the additional administration of Pyrazinamide. Surgical treatment was performed for the remaining 5 cases, and all 5 cases were cured completely after additional antituberculous medication for 6 months. CONCLUSIONS: We conclude that the best choice for the treatment of tuberculous cervical lymphadenintis is the use of both surgical excision and antituberculous medication. In addition, the use of Pyrazinamide is recommended for the antituberculous medication.
Drainage ; Ethambutol ; Female ; Humans ; Isoniazid ; Korea ; Lymphadenitis* ; Male ; Pyrazinamide ; Recurrence ; Rifampin ; Tuberculosis

Sarcoidosis is a disease of unknown cause characterized by the presence of noncaseating granulomatous inflammation. Because the lungs and thoracic lymph nodes are almost always involved, most patients report acute or insidious respiratory problems. Although pulmonary manifestations are usually the major clinical concern in sarcoidosis, extrapulmonary involvement is common. We report a case of sarcoidosis of the axillary lymph nodes with no evidence of lung alteration.
Humans ; Inflammation ; Lung ; Lymph Nodes* ; Sarcoidosis*

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic