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

PURPOSE: To evaluate the prevalence and the patterns of sterile gas shown at computed tomography(CT) after transarterial embolization(TAE) for primary hepatic tumor. MATERIALS AND METHODS: Among 102 patients who performed TAE for hepatoma, thirty-four in whom follow-up CTwas underwent constituted the basis of our study. At CT, we evaluated the patterns and locations of intratumoral gas. We also reviewed the clinical data to exclude an infectious origin of intratumoral gas. RESULTS: Of 34 patients, intratumoral gas was detected in 11 patients(32%), in all of whom Gelfoam was used as an embolic material. The initial tumor size measured at pre-TAE CT was larger in patients with intratumoral gas than in patients without it(p < 0.005). No specific patterns or locations of intratumoral gas were noted on CT scans. No patients had clinical signs and symptoms that suggested infection. CONCLUSION: Intratumoral gas formation without clinical evidence of infection is not an infrequent finding after TAE for hepatoma, especially when Gelfoam is used and when the tumor is large in size. This finding may be a part of postinfarction syndrome and should not be misinterpreted as an postprocedural abscess formation.
Abscess ; Carcinoma, Hepatocellular ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Prevalence ; Tomography, X-Ray Computed

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

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*

BACKGROUND: It was recognized that the intake of the whole cow's milk(WCM) early (before 1 year old of age) and large amount in early childhood is related to the iron deficiency, sometimes the iron deficiency anemia in advanced state. To verify the relationship between the variables in the WCM intake and the iron status, we carried out this study. METHODS: Thirty subjects(1 year to 3 years old of age) were classified as a WCM large intake group and a WCM small intake group. The relationship between the WCM commencing age and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large intake group was evaluated and analyzed by the linear regression. Futhermore, the relationship between the value of WCM intake amountxduration/10 and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large and small intake groups was evaluated and analyzed by the linear regression. RESULTS: As the WCM commencing age was earlier, the values of serum ferritin, transferrin saturation and hemoglobin decreased significantly(P<0.05). The values of serum ferritin and transferrin saturation decreased significantly as the value of WCM intake amountxduration/10 increased(P<0.05). But the value of hemoglobin decreased insignificantly as the value of WCM intake amountxduration/10 increased(P>0.1). CONCLUSION: The variables in the intake of WCM influence upon the iron status in early childhood. The early commencing of the WCM(before 1 year old of age) is the worst variable that influences adversely upon the iron status in early childhood. The amount of WCM intake and the duration influence upon the storage iron(serum ferritin and transferrin saturation), but not hemoglobin. In this regard, it is necessary to inform the parents of the correct WCM intake ways to avoid the irreversible recognition impairment and behavioral change.
Anemia, Iron-Deficiency ; Child, Preschool ; Ferritins ; Humans ; Iron* ; Linear Models ; Milk* ; Parents ; Transferrin

This is a retrospective clinical analysis of 27 cases of pancreatic pseudocysts that were treated at the Department of Surgery, Chung Goo Sung Sim Hospital, from 1988 to 1996. The results are as follows:1) The ratio of males to females was 12.5 :1, and the highest incidence was in the 4th decade. 2) Acute & Chronic Pancreatitis was most frequently associated with pancreatic pseudocysts (72.4%). 3) The most frequent symptom of patients with a pancreatic pseudocyst was abdominal pain (92.5%), and the most common site of the pancreatic pseudocyst was the tail of the pancreas (55.6%). 4) Of the 7 cases involving pseudocysts of less than 5 cm, 6 cases were managed conservatively and 1 case surgically . In the 15 cases with sizes from 5 cm to 10 cm, percutaneous catheter drainage was performed in 7 cases, with sizes larger conservative management in 5 cases and surgical management in 4 cases. In the 5 cases with sizes larger than 10 cm, percutaneous catheter drainage was performed in 3 cases and surgical management in 1 case. 5) Cases involving conservative management and percutaneous drainage (average:31 & 34 days), respectively had shorter hospital stays than surgical menagement (42 days). 6) Complications of pancreatic pseudocysts, such as intra-abdominal abscesses, cutaneous fistulas, pulmonary complications, wound infection, leakage or rupture, etc, were relatively common after surgery. In conclusion, we propose that conservative management and percutaneous catheter drainage are first-line treatment modalities for pancreatic pseudocysts if the clinical conditions of the patient can tolerate them.
Abdominal Abscess ; Abdominal Pain ; Catheters ; Cutaneous Fistula ; Drainage ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis, Chronic ; Retrospective Studies ; Rupture ; Wound Infection