As the development of the percutaneous renal surgery, Ureteropelvic junction obstruction can be treated with endourologic technique instead of open surgery. Precutaneous endopyelotomy has been used mainly for the treatment of secondary ureteropelvic junction obstruction. But it was also successful for treatment of primary ureteropelvic junction obstruction. Recently, we performed endopyelotomy for 3 cases of ureteropelvic junction obstruction a 39 years-old male who had renal pelvic stones combined with ureteropelvic junction, a 32 years-old male with ureteropelvic junction obstruction and a 23 years-old male who had horseshoe kidney combined with ureteropelvic junction obstruction and good results were obtained.
Adult ; Humans ; Kidney ; Male ; Young Adult

No abstract available.
Abdominal Pain ; Colonoscopy ; Detergents ; Eating

PURPOSE: The contribution of perforating vein incompetence to the hemodynamic derangement in the chronic venous disease (CVD) remains a topic of debate. This study was designed to define the characteristics of IPV according to CEAP classification with development of CVD. METHOD: From March 1999, to August 2001, 145 patients were treated for CVD in our hospital. Of these, 15 patients with CEAP class 4, 5, 6 (Group I) and 130 patients with class 2 (Group II). Medial side of calf was assessed in the sitting position for looking IPVs by duplex scan. The number, location, and diameter at the fascia level of IPVs were determined. The characteristics of IPVs between two group were compared. Airplethysmogram (APG) was checked pre and postoperatively in 18 patients with class 2 without any procedure to IPVs. RESULT: 17 IPVs were found in 11/15 (73%) patients in group I, and 36 IPVs were found in 29/145 (20%) in group II. The mean number of IPVs in each limb of group I and II was 1.54, 1.09 (P>0.05) and the mean diameter was 0.52 cm, 0.38 cm (P=0.001). The 96% (51/56) of IPVs were found in lower half of the calf. All hemodynamic parameter of APG was improved statistically significantly after operation without ligation of IPVs in class 2 patients. CONCLUSION: With advancing of CVD (class 4, 5, 6), IPVs was found more and larger. This suggest significant hemodynamic role of IPVs in progression of CVD. So careful attention should be payed to IPVs in treatment of CVD. But it was doubted benefit of direct treatment of IPVs in class 2.
Classification* ; Extremities ; Fascia ; Hemodynamics ; Humans ; Ligation ; Veins*

PURPOSE: The autologous greater saphenous vein (GSV) is the most frequently used graft for leg artery bypass. But vein harvesting with long open incision as traditional method can be complicated by wound problem. Since we experienced endoscopic vein harvesting in leg artery bypass, we reviewed its advantage and indication. METHOD: Six patients received the endoscopic saphenous vein harvesting procedure for their leg artery bypass surgery. The endoscopic procedure was limited above knee avoiding of the injury to saphenous vein because it has more branching at below knee. We studied endoscopic using time, number of branch ligated, wound closure time, wound complication, postoperative pain and admission duration. RESULT: In one patient the procedure was failed because many branch and small GSV. In five patients mean endoscopic using time was twenty two minutes and 2.2 branch was ligated. There was no wound complication. Wound closure time and operation time was decreased but the statistical variables difficult to decide. In one patient for redo operation, contralateral GSV was harvested. CONCLUSION: Endoscopic GSV harvesting is technically simple procedure, which can reduce wound size in using reversed way of GSV in leg artery bypass. We also believe it reduce operation time, wound pain, hospital stay. But it needs further study and skill in our study.
Arteries* ; Humans ; Knee ; Leg* ; Length of Stay ; Postoperative Complications ; Saphenous Vein* ; Transplants ; Veins ; Wounds and Injuries

A temporary balloon occlusion of internal carotid artery (ICA) was performed in 3 patients for carotid artery endarterectomy and 1 patient require sacrifice ICA with neck malignancy. EEG monitoring and neurologic evaluation was done during the test. In one patient who has bilateral ICA stenosis more than 95% shows slurred speech and aphasia during test. Another 3 patients shows no clinical change during test, and operation was done without shunt. There were no postoperative neurologic complication. We believe that preoperative balloon occlusion of ICA provide another helpful criteria to decide using shunt. But it needs another hemodynamic analysis tool according to other's report.
Aphasia ; Balloon Occlusion ; Carotid Arteries* ; Carotid Artery, Internal ; Constriction, Pathologic ; Electroencephalography ; Endarterectomy ; Hemodynamics ; Humans ; Neck

To present MR imaging findings of intracranial lesions in systemic lupus erythematosus(SLE), a retrospective study was performed on MR images of 33 SLE patients with neurologic symptoms and signs. MR imaging was performed on either a 0.5T (21 patients) or 2.0T unit (12 patients), using T1-weighted, proton-density-weighted, and T2-weighted spin echo sequences in all patients. In seven patients, post-contrast T1-weighted images were also obtained after administration of gadopentetate dimeglumine. The main MR findings consisted of focal lesions suggesting ischemia/infarct (15 patients), diffuse brain atrophy (8), and findings associated with infection (4). The MR findings were normal in 11 patients(33%). The focal lesions suggesting ischemia/infarcts presumably secondary to vasculitis were distributed in the cortex or subcortical white matter (7 patients), deep periventricular white matter (3), or in both areas(5). Most of the focal lesions were multiple and small in size. The findings associated with infection were variable and included communicating hydrocephalus, meningeal enhancement, granuloma, etc. MR findings of SLE were non-specific and therefore clinical correlation is needed when evalating SLE in MR.
Atrophy ; Brain* ; Gadolinium DTPA ; Granuloma ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Retrospective Studies ; Vasculitis ; White Matter

PURPOSE: We report our early experience, and the feasibility, of an endovascular technique for treating iliac vein compression syndrome, which is known to be caused by a chronic pulsating irritation of the iliac artery. METHODS: Five patients presented with acute deep vein thromboses in their left legs, diagnosed by computed tomography (CT), and treated with a catheter-directed thrombolysis. The residual stenosis was treated by angioplasty, followed by stent placement. The results were evaluated, followed with duplex ultrasound. RESULTS: The CT scan of the left iliac vein was compressed by the right iliac artery, with the thrombosis shown distal of the venous segment of the crossover point in all five cases. Success with the endovascular technique was achieved in all 5 patients. In the follow up, the duplex scan stent site and patency were examined. During the follow up period all the stents were patent, and no thrombosis recurred. CONCLUSION: A CT scan is helpful in diagnosing iliac vein compression syndrome, with a thrombosis. The endovascular approach for its treatment should be considered affirmative due to its safety and simplicity.
Angioplasty ; Constriction, Pathologic ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery ; Iliac Vein* ; Leg ; May-Thurner Syndrome* ; Stents ; Thrombosis* ; Tomography, X-Ray Computed ; Ultrasonography ; Venous Thrombosis

PURPOSE: To assess the suitability of multidetector row CT angiogram (MDCTA) as the sole preoperative imaging for infrainguinal arterial surgery. METHOD: From March 2002 to September 2003, 75 patients (24 claudicants, 41 limb-threatening ischemia) were studied with MDCTA preoperatively. We compared the surgical inflow and outflow site changes between preoperative planning based on MDCTA and the results of final operation. MDCTA was interpreted by the same vascular surgeon, and arterial segments from the renal artery to foot were reviewed. Surgery plans were formulated based on arterial anatomic and hemodynamic characteristics. Additional diagnostic value and test related complications were also studied. RESULT: Twenty- one patients had conventional angiogram after MDCTA scan - 9 for interventional treatment at inflow site and 12 patients for complement of MDCTA, although the operation plan was not changed. The agreement between preoperative plan based on MDCTA and final operation was 100% even in critical limb ischemia. In 11 patients tortuous calcified iliac artery was ambiguous in routine image but it could be solved using the other specific functional option of MDCTA. There were no serious complications related to the test. CONCLUSION: These findings suggest that MDCTA is an adequate preoperative imaging study of infrainguinal arterial surgery and that it may be substituted for conventional angiogram without any serious complication. The particular functional options of MDCTA help resolve its defect.
Complement System Proteins ; Extremities ; Foot ; Hemodynamics ; Humans ; Iliac Artery ; Ischemia ; Renal Artery

Malignant fibrous histiocytoma (MFH) is recognized as the most common soft tissue sarcoma in adult. But it is very rare in head and neck region with less than 100 cases reported in literature. Treatment of choice for MFH is surgery. For wide surgical excision, usually carotid artery resection is unavoidable. For preventing neurologic sequelae we did preoperative carotid artery balloon occlusion test with EEG monitoring. Greater saphenous vein was used for interposition graft.
Adult ; Balloon Occlusion ; Carotid Arteries* ; Electroencephalography ; Head* ; Histiocytoma, Malignant Fibrous* ; Humans ; Neck* ; Saphenous Vein ; Sarcoma ; Transplants

The most common limiting factor in arterio-venous fistula operation (AVF) is the lack of a suitable native vein. So preoperative assessment of venous system is essential for successful results. But simple physical examination alone is not enough to assess in many cases. To evaluate difference between venogram results with physical examination, 20 patients (group A) imaged with venogram preoperatively compared with 20 patients (group B) who examined only physically. In group A, all patients palpated thrill in immediate post operation and one patient revealed fistula occlusion within post operative 2 months. In group B 4 patients revealed failed fistula within 24 hours and 5 fistula failed in 2 months. Twelve patients (>50%) of group A showed different results in venogram compared with physical examination, which influenced type of operation. Physical examination alone was not enough to assess venous system and venogram provided valuable information in AVF constructive surgery.
Fistula ; Humans ; Physical Examination ; Veins