Six cases of right external iliac and common femoral arterial thrombotic occlusions following transfemoral cardiac catheterization were found among the 117 infants and children with congenital heart disease. Physical findings of arterial thrombosis were lower extremity coldness and absence of femoral pulse, which appeared just after cardiac catheterization. Transcatheter local intrathrombotic infusion of Urokinase were done with 50000 IU bolus doses and 40000-50000 IU/h running doses. All 6 cases showed complete thrombolysis and re-establishment of femoral circulation. Three cases developed bleeding from arterial puncture sites, and were subsequently controlled properly by compression. No other complication was found. Our results suggest that local thrombolytic therapy with Urokinase is effective treatment method without significant complication for the infants and children with fresh thrombotic occlusions following cardiac catheterization and angiography.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Catheterization* ; Catheters* ; Child* ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant* ; Lower Extremity ; Methods ; Punctures ; Running ; Thrombolytic Therapy* ; Thrombosis ; Urokinase-Type Plasminogen Activator*

After the percutaneous transarterial technique was introduced by Seldinger in 1953, the percutaneous transcatheter embolization technique was developed. Autologous clot, first used by Doppman in 1968 to occlude a spinal arteriovenous malformation, was quickly adopted for management of gastrointestinal hemorrhage, genitourinary hemorrhage, traumatic hemorrhage, and hemoptysis. The notable improvement of the angiographic techniques rendered the interventional treatment the mainstay in the management of bleeding. Interventional treatment can be a life-saving procedure for massive bleeding or an important adjunct in reducing blood loss during operation and occasionally radical treatment of bleeding diseases. The goal of embolotherapy is to reduce the pulse pressure in the bleeding artery while maintaining an enough collateral flow to preserve the tissue viability. A variety of embolic materials have been proved safe and effective. Gelfoam pledget, polyvinyl alcohol, and coil are most commonly used. Gelfoam powder, extremely small polyvinyl alcohol, and absolute alcohol should be used carefully because of the risk of mucosal ischemia and necrosis.
Arteries ; Arteriovenous Malformations ; Blood Pressure ; Embolization, Therapeutic ; Ethanol ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemoptysis ; Hemorrhage* ; Ischemia ; Necrosis ; Polyvinyl Alcohol ; Tissue Survival

No abstract available.

No abstract available.
Dizziness* ; Pallor*

Antral web is a very rare cause of vomiting in child, known to be a congenital disorder caused by incomplete recanalization of embryonic foregut, and in almost cases treated surgically. Author experienced a case of antral web in a 4-year-old boy who had suffered from severe abdominal pain for 2 months, in whom erosive duodenitis was noted on endoscopic examination. The patient became symptomfree after 1 week of conservative treatment for duodenitis. No specific therapy was not required for the antral web. Author concluded that surgical treatment is indicated for the clinically severe cases.
Abdominal Pain ; Child* ; Child, Preschool ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Duodenitis ; Humans ; Male ; Vomiting

No abstract available.
Colon, Ascending*

No abstract available in English.
Lower Extremity

Pecutaneous transhepatic portogram with selective catheterizatio of the portal vein and its tributaries notonly provide information about the status of portal circulation and but can also be used in the treatment ofbleeding esophageal varices by selective embolization with various embolic materials. The authors describe easierand safer modified method of conventional percutaneous transhepatic portogram. We wish to describe our experiencewith the technical aspects and portosystemic collateral patterns in 26 patients with variceal bleeding, from July1985 to July 1986 at Kyungpook National University Hospital. 1. To overcome the difficulties of catheter passageand superselection of variceal supplying vein, we used 7F sheath directly introduced over the ,018″ guide wire.We used coaxial system using 25cm 18G needle within 7F vessel dilator to make the tip of dilator more rigid. 2.Variceal obliteration attempted in 23 patients who showed variceal supplying veins on the protogram, Successfulobilteration was obtained in 20 patients. We used absolute ethanol, stainless steel coil, and Gelfoam cubes withsclerosing and embolica agent of variceal vein. 3. Portosystemic collaterals of 24 patients; Coronary vein;21cases, Inferior mesenteric vein:9 cases, Short gastric vein:7 cases, Umbilical & paraumbilical vein; 6 cases,Gastrorenal: 3 cases, Splenorenal: 2 cases, Splenoretoperitoneal: 1 case. 4. The number of coronay vein were 18cases of single and 4 cases of two. The locations of coronary vein: Splenic vein: 13 cases, Main portal vein: 7cases, Junctional area: 6 cases. 5. Transhepatic obliteration of the gastroesophageal veins is a relatively simpleand usually successful form of palliative treatment for actively bleeding and stable gastroesophageal varices.
Catheters ; Coronary Vessels ; Esophageal and Gastric Varices ; Ethanol ; Gelatin Sponge, Absorbable ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Methods ; Needles ; Palliative Care ; Portal Vein ; Splenic Vein ; Stainless Steel ; Varicose Veins ; Veins

PURPOSE: We reviewed 13 cases of pancreatic pseudocysts treated by percutaneous catheter drainage to determine the value and effectiveness of the procedure. MATERIALS AND METHODS: Sixteen pancreatic pseudocysts(nine infected, seven noninfected) were drained in 13 patients. Access routes were determined by images on CT scan and procedures were performed under fiuoroscopic guidance. Ultrasonogram was used as a guide for drainage when there were bowel loops near the access routes. Various access routes were used for catheter drainage:transperitoneal (10), retroperitoneal (3), transsplenic (2) transhepatic (1). RESULTS: Percutaneous catheter drainage cured 15 of 16 pancreatic pseudocysts(93.8%). No recurrance was encountered in the clinical follow-up of 7 to 69 months(mean 35 months). The mean duration of drainage was 29 days(infected, 24 days; noninfected, 39 days). Five pseudocysts(31%) were communicated with pancreatic duct The mean duration of drainage in these cases was 38 days. Spontaneous of the pancreatic pseudocysts to the gastrointestinal tract was occurred in 3 pseudocysts. Mean duration of drainage in pseudocysts with fistulas was 19 days. CONCLUSION: Percutaneous cather drainage is a safe and effective front-line treatment method in most pancreatic pseudocysts if drainage is done with a adequate follow-up and catheter care.
Catheters ; Drainage* ; Fistula ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Tomography, X-Ray Computed ; Ultrasonography

This study was conducted to invetigate the effect of high-dose steroid administration on adipogenesis and secretion of PAI-1 in rat. Sixty healthy Wistar rats were divided into three groups. Group A consisted of 20 control animals received 5 ml/kg isotonic saline for 1 weeks. Group B consisted of 20 animals received 10 ml/kg of methylprednisolone intraperitoeally for 1 week. Group C comprized 20 animals received 10 ml/kg of methylprednisolone intraperitoneally for 1 week. After the completionof treatment, blood sampling was performed for measurenement of PAI-1 and the animale were sacrificed for histopathologic examination and immunohistochemical study. The PAI-1 protein expressin of femoral heads were evaluated with Western-blotting. Blood level of PAI-1 increased significantly in high-dose steroid treated group(Group B and C) compared to control group. In histopathologic examination, significant fat morrow conversion, fat cell hypertrophy and fat cyst formation were observed in high-dose steroid treated group. Immunohistochemically, PAi-1 expression was sprominent in the fat cells. Protein expression of PAI-1 of femoral heads increased significantly in highdose steroid treated group compared to control group. In lights of above results, it is postulated that increased secretion of PAI-1 from fat cells could play a major role in the pathogenesis of osteonecrosis of the femoral head in rats treated with high-dose steroid.
Adipocytes ; Adipogenesis* ; Animals ; Head ; Hypertrophy ; Methylprednisolone ; Osteonecrosis ; Plasminogen Activator Inhibitor 1* ; Rats* ; Rats, Wistar