Percutan eous biliary d ilation was done in 3 patients wi th benign strictures. Th e first case was 50.year-old male who had mu ltiple intrah epatic stones w ith bilia ry strictu re. The second 46-yea r-o ld femal e and th e third 25-year-old male suffe red from recurrent cholangitis with beni gn stricture of anastomotic site after chol edocho-'eJunostomy | 끼 the first case, a 6mm diameter Grünzig dilatation ba ll oon catheter was in troduced th ro ugh th e T-tube tract. ln th e second case, the stricture was di lated w ith two balloons 01 5mm and 8mm in each diameter sequentially through the U-Ioop tract formed b y surgical ly ll1 ad e jejunostom y and percutaneous tra nshepatic puncture . ln th e third case, th e dilatation cathete r was introduced thro ugh the percutaneous transhepatic tract Dil atation was made with a press ure of 5 to '10 atmospheres for 1 to 3 minutes dural'i on for 3 times In all 3 cases, the stri ctures 、v e r e succ essful ly dilated and in second and third cases internal stent was left across th e les ion fQ r prevention of res tenosis -317-
Mitral stenosis, the most frequent heart disease in adult, showed relatively characteristic pulmonary findings in plain chest X-ray. ln recent years the knowledge of the altered physiology of hemodynamics could offer considerable amount of hemodynamic barrier in plain chest. But the value of several parameters was still controversia1. ln this study a variety of roentgen signs were related to physiologic data and these were acquired by the cardiac catheteri zation in total of 67 cases of mitral st enosis.1. Correlation of DPA/ DHT ratio ( Diameter of pulmonary arterial segment/ Diameter of hemithorax X100)to hemodynamic data: The pulmonary arterial segment was dilated by two factors, the one was pulmonary blood f10w and the other the blood pressure within it. ln mitral stenosis, the cardiac output was decreased to quite llniform level, hence measurement of pulmonary arterial segment might be val uable. The correlation coefficient of DPA/ DHT ratio to hemodynamic datas were as fol1ows: 0.54 to mean plllmonary artery pressure, 0.32 to plllmonary capillary wedge preSSllre, -0. 37 to mitral valVlllar area and 0.07 to plllll10nary vasclllar res ist ence. No significant difference was noted in between pure mitral stenosis and mitral stenosis associated with other valvular disease.2. Correlation of diameter of right descending plllmonary artery to hemod ynamic data: The measurell1ent was made near the fi rst bifllrcation of right descending Plllmonary artery at its widest point .Plllmonary vasclllar pattern was best correlated (r=O.71). Another had rough correlation: 0. 05 to ll1ea n p111ll1onary a rtery preSSllre, 0.31 to p111monar y capi1lary wedge preSSllre, -0.44 to mitral valvlllar area in correlation coefficient. No plllmonary arterial hypertension was observed in the cases diameter of less than 121l11l1, bllt all except two cases had pulmonary hypertension in which diameter exceeded 16mm. According to increase of the mean pulmonary arterial pressure, the same increment in pressure increased change prodllced progressively smaller degrees of di1atation of main pulmonary artery and right descending pulmonary artery. Quite frequently primary pulmonary arterial segment and right descending pulmonary artery were enlarged with all degrees of pulmonary hypertension and which made enlargement of pulmonary artery as a sign but little value in determining the degree of ' pulmonar.y h -2 9 -
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