PURPOSE: Since ESWL had been developed, many experiences of the treatments to urinary stones with various type of lithotriptors were reported. We evaluated the efficacy of EDAP-LT01 piezoelectric lithotriptor according to the size, location of the stone, number of the treatment session, adjuvant therapy and cause of failure. MATERIALS AND METHODS: We retrospectively analyzed the data of 660 cases who had been treated with ESWL. Among the patients, the renal stones were 122, the ureteral stones were 452, and combined with renal and ureteral stones were 43 cases. The mean size of stones was 13mm (range: 4-38mm). ESWL was performed to all the patients with urinary stones except complete staghorn calculi. No anesthesia was performed except in one child (5 years old). RESULTS: Overall success rate was 94.7%, and there were close correlations between the success rate and the size. The mean number of sessions was 2.4. There was no significant complication, but 35 cases were failed by ESWL monotherapy, and auxiliary procedures were done in 21 cases. Efficiency quotient was 0.59. CONCLUSIONS: The ESWL with EDAP-LT01 seems to be effective and safe to treat the urinary stones of various location and size, even compared to the lithotriptors of other type. We also propose that ESWL monotherapy with this machine is efficient for the treatment of the partial staghorn calculi and stones larger than 30mm.
Anesthesia ; Calculi ; Child ; Humans ; Lithotripsy* ; Retrospective Studies ; Shock* ; Ureter ; Urinary Calculi

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

After the performance of 100 coronary cineangiographies in 100 paitents who were adminitted to Soonchunhyang University Hospital under the diagnosis of ischemic heart disease from July 1986 to October 1987, we observed the coronary collateral circulation and measured the ejection fraction, circumferential fiber shortening, left ventricular end-diastolic pressure and pulmonary artery wedge pressure in 52 paitents who had 50% or more stenosis in one or more coroanry arteries. The results were as follow : 1) The collaterall circulation was observed in 16 patients(30.8%) of the 52 patients and it was developed mainly(87.5) in patients with 90% or more coronary artery stenosis. In patients with stenosis of less than 90%, however, collateral circulation was observed rarely(12.5%). 2) The left ventricular wall motion abnormality was severe in the group without collateral circulation. 3) The collteral circulation was most frequently developed in patients with severe right coronary artery stenosis and most of the routes were supplied from contralateral coronary arteries. 4) There was no significant difference in ejection fraction, circumferential fiber shortening, left ventricular end-diastoic pressure and pulmonary artery wedge pressure between the 2 groups with and without coronary artery collateral circulation.
Arteries ; Cineangiography ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Humans ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Ventricular Function, Left*

A clinical observation was made with particular attention to radiologic diagnosis, complication and management on 69 patients of renal injury admitted to the Catholic Medical Center during the last 10 years. The results were as follows: 1. Minor renal injury was in 49 cases (71%), major renal injury in 19 cases (27.5%) and pedicle injury in 1 case (1.5%) according to Scott's classification. 2. IVU was performed in 68 cases for initial diagnostic study and 18 cases (31%) needed additional radiologic study for accurate staging. 3. CT was performed in 14 cases and its diagnostic accuracy was 93%. 4. Renal angiography was performed in 6 cases. Angioinfarction was performed in 1 case due to continuous bleeding and the other 5 cases showed localized parenchymal infarction or normal finding. 5. Sonography was performed in 6 cases for initial diagnostic study and in 3 cases for follow up study. 6. In major renal injury patients, the group which decided treatment after CT study revealed 16 7% of complication rate but the group which decided treatment without CT study revealed 38 5% of complication rate. 7. In major renal injury or pedicle injury patients, initial operative treatment group resulted in kidney loss in 70% of cases without complication but initial conservative treatment group resulted in kidney loss in 60% of cases and the delay of operation resulted in 70% of complication rate.From these results, CT is the choice of additional staging technique after initial IVU and initial surgical operation is adequate treatment procedure in major renal injury or pedicle injury patients.
Angiography ; Classification ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Kidney

No abstract available.
Humans ; Recurrence*

No abstract available.
Steatocystoma Multiplex*

No abstract available.
Histiocytic Necrotizing Lymphadenitis* ; Lymphohistiocytosis, Hemophagocytic*

It is well known that small dose of belladonna alkaloid(atropine, scopolarnine) has the effect of decreasing the heart rate in normal conscious subjects, but the mechanism involved in it remains still unanswered. Based on various lines of evidence, the most likely mechanism seems to be the blockade of sympathetic ganglion caused by the alkaloids and it is possible that the effect on the slower heart rate may differ in the depressed state of the sympathetic ganglion when under halothane anesthesia. The present study was undertaken, therefore, on comatose patients and halothane anesthetized patients with and without atropine premedication about 1 hour before anesthesia to observe the effect of a small dose of scopolamine(0.1 mg) which affects the heart rate more significantly than atropine in conscious subjects. The results were as follows: 1) In the comatose patients, scopolamine(0.1 mg) produced a significant decrease in heart rate. 2) During halothane anesthesia without atropine premedication, scopolamine produced a slight decrease in heart rate. 3) During halothane anesthesia with atropine premedication, scopolamine produced a significant increase in the heart rate. These results indicate that scopolamine can further affect the sympathetic ganglion already depressed by halothane, and it is suggested that scopolamine is more effective in blocking the sympathetic ganglion than halothane.
Alkaloids ; Anesthesia ; Atropa belladonna ; Atropine ; Coma ; Ganglia, Sympathetic ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Premedication ; Scopolamine Hydrobromide*

Although severe hemolytic diseases of the newborn triggered by anti-M are very rare, anti-M alloantibodies have been known to be associated with a cause of multipie intrauterine death. Serological and hematological investigations have been reported on a woman who experienced four multiple intrauterine deaths due to anti-M. The mothers blood type was of group A, NN and the husbands cells were of group B, MN. In the serological examination at 9th week's gestation of the fifth pregnancy, anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 16 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4 at 37 degrees C. She underwent high-dose immunoglobulin infusion therapy on a monthly program from 3rd month gestation and a total of 6 times of intravenous immunoglobulin was given. The anti-M titer did not rise during the pregnancy. She delivered a live girl by cesarean section at the 37th week because of a failure of induction. The childs blood type was of group O, MN. The child was discharged and developed normally.
Antibodies ; Cesarean Section ; Child ; Female ; Humans ; Immunization, Passive* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant, Newborn ; Isoantibodies ; Mothers ; Pregnancy* ; Spouses

Vesicoureteral reflux (VUR) is common disease found in up to 70% of children who have urinary tract infection, and the various type of antireflux surgerys were used to correct the problem. Among them, Gil-Vernet antireflux technique is a useful method and it has many advantages such as procedure of simplicity, shorter operative time, and lower complication rate along with maintaining high success rate. We present six cases of vesicoureteral reflux who had been managed with Gil-Vernet antireflux technique, and review the advantages, disadvantages, complications, and usefulness of the procedure.
Child ; Humans ; Operative Time ; Urinary Tract Infections ; Vesico-Ureteral Reflux*