Measurement of bone mineral density(BMD) of the spine may be affected by the presence of various factors such as osteophytes, osteosclerosis and spinal deformity, particularly in elderly persons. Therefore the accurate evaluation for osteoporosis is difficult in osteoarthritic spine and until now no technique can evaluate true mineral density of the osteoarthritic spine. So we performed this study to evaluate the effect of osteoarthritic changes of the spine on the BMD and various BMD values such as young-adult% and age-matched%. Additionally we evaluated the diagnostic value of the Singhs index in the advanced osteoporotic spine. We reviewed 50 patients with advanced osteoporosis of the spine retrospectively and they were divided into two groups; one consisted of 22 patients with osteoporosis alone and the other consisted of 28 patients with osteoporosis and osteoarthritic change on the spine. The measured mean BMD value in AP plane and that expressed in relation to reference data for young adults(young-adult%) of the patients with arthritic and osteoporotic spine were significantly higher than those of the patients with osteoporosis alone. On the other hand, values expressed in relation to the age and sex matched mean reference data(age-matched%) were not significantly higher in group of patients with osteoporosis and osteoarthritic change, and Singh s index was not diagnostic for the osteoporosis of the spine. But young-adult% were significantly lower than agematched% even in the osteoarthritic group. We concluded that young-adult% is mare useful value for diagnosis of the advanced osteoporosis in the osteoarthritic spine.
Aged ; Bone Density* ; Congenital Abnormalities ; Diagnosis ; Hand ; Humans ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Osteosclerosis ; Retrospective Studies ; Spine*

Capsule contraction syndrome is severe constriction of the anterior capsular opening and equatorial capsular bag diameter after extracapsular cataract surgery. It is relatively common in patients with continuous curvilinear capsulorhexis, but rarely in can-opener capsulotomy or anterior radial capsular tears. It is due to capsular bag contraction from fibrous dysplasia of residual lens epithelial cells with weakened zonular resistance. We experienced a case of capsule contraction syndrome in a 72-year old woman with retinitis pigmentosa, who had phacoemulsification following an intact 5.0mm-continuous curvilinear capsulorhexis 4 months before. After successful YAG laser radial anterior relaxing capsulotomy, her visual acuity restored to 0.3, limited by cystoid macular edema.
Aged ; Capsulorhexis* ; Cataract ; Constriction ; Epithelial Cells ; Female ; Humans ; Lasers, Solid-State ; Macular Edema ; Phacoemulsification ; Retinitis Pigmentosa ; Visual Acuity

OBJECTIVE: Our purpose was to complete delivery during daytime through rapid and safe management with oral prostaglandin plus oxytocin, and to reduce the duration of induced labor, hospital stay and dispersion of human power. METHODS: Ninety pregnancies requiring induction of labor between December 1998 and July 1999 were analyzed prospectively. Patients were assigned to receive either oral PGE2 or oral PGE1. In one group, labor induction was performed with 0.5 mg of oral PGE2 (group 1, n=46), was orally taken every one hour since 06:00 AM to 09:00 AM and intravenous oxytocin infusion (The beginning dose was 2 mU/min, the dose increased by 2 mU/30 min) beginning at 09:00 AM, and in the other group (group 2, n=44), 100 microgram of PGE1 was orally taken at 11:00 PM the day before oxytocin infusion was commenced at 07:00 AM. If there was uterine contraction of more than 200 Montevideo units, intravenous oxytocin would not be given. RESULTS: The mean time (+/-standard deviation) to active phase labor (cervical dilatation more than 3 cm and uterine contraction more than 200 Montevideo units) with PGE2 group was 335.16+/-157.89 minutes versus 534.16+/-211.79 minutes with PGE1 group (P<0.001). The mean time from active phase to birth was 182.8+/-93 minutes in group 1 versus 236.4+/-88.8 minutes (P<0.001). These significances were due to the difference of time interval from taking prostaglandins to infusion of oxytocin between the two groups. The time zone of expected delivery was 13:28 PM to 15:48 PM and 10:22 AM to 13:18 PM (Confidence Interval 95%). The induction failure rates were 10.87% versus 9.09%. The induction failure rate was significantly different according to Bishop score (if <4, 15.3% versus if >or= 4, 0%) and the cesarean section rate was also (if < 4, 40.7% versus if >or= 4, 19.4%) in the two groups (P<0.05). There were no clinical or statistical differences in demographic data, clinical characteristics, maternal outcomes and complications, and neonatal outcomes. CONCLUSION: Both may be proper methods of inducing delivery during daytime and begun at outpatient office base.
Alprostadil ; Cesarean Section ; Dilatation ; Dinoprostone* ; Female ; Humans ; Labor, Induced ; Length of Stay ; Outpatients ; Oxytocin* ; Parturition ; Pregnancy ; Prospective Studies ; Prostaglandins ; Uterine Contraction

Excessive peak airway pressure during general endotracheal anesthesia may result from bronchospasm due to light anesthesia or surgical stimulation, bronchial intubation, tension pneumothorax, pulmonary edema, or mechanical obstruction of tube, whether from kinking, inspissated secretions, or overinflation of the cuff. Usually these problems are differentiated with auscultation and drug administration. However, mechanical problems associated with the endotracheal tube may be a cause of increased airway pressure. Reinforced, anode, or armored tubes consist of two coatings of latex or PVC that enclose spiral metal windings. Because of that, the inner layer may peel away, and intraluminally bulge due to nitrous oxide and cause airway obstruction during the course of an anesthetic process. We report a case of intraluminal bulging of the inner layer in a reinforced tube using fiberoptic bronchoscopy during anesthesia.
Airway Obstruction ; Anesthesia* ; Auscultation ; Bronchial Spasm ; Bronchoscopy ; Electrodes ; Intubation ; Latex ; Nitrous Oxide ; Pneumothorax ; Pulmonary Edema ; Wind

Venous thrombosis is uncommon in young individuals. Hypereosinophilia is a rare cause of thrombosis that usually involves the heart and small vessels like retinal vessels. We report a case of massive deep vein thrombosis that developed in a young patient with hypereosinophilia who was successfully treated with continuous local infusion of urokinase.
Eosinophilia* ; Heart ; Humans ; Retinal Vessels ; Thrombosis ; Urokinase-Type Plasminogen Activator* ; Venous Thrombosis*

BACKGROUND: The 5-hydroxytryptamine type 3 (5-HT3) receptor is a member of the Cys-loop superfamily of ligand-gated ion channels (LGICs) and modulated by pharmacologic relevant concentrations of volatile anesthetics or n-alcohols like most receptors of LGICs. The goal of this study was to reveal whether the site-directed single mutations of E-106, F-107 and R-222 in 5-HT3 receptor may affect the anesthetic modulation of halothane known as positive modulator. METHODS: The wild-type and mutant receptors, E106D, F107Y, R222F, R222V, were expressed in Xenopus Laevis oocytes and receptor function was assessed using two electrode voltage clamp techniques. RESULTS: E106D, F107Y, R222F, R222V mutant 5-HT3A receptors were functionally expressed. F107Y mutant 5-HT3A receptors displayed decreased sensitivity to 5-HT compared to the wild type 5-HT3A receptor (P < 0.05). Halothane showed positive modulation in both wild and F107Y mutant 5-HT3A receptors but F107Y mutant 5-HT3 receptor showed greater enhancing modulation comparing to wild-type receptor. Meanwhile, R222F and R222V mutant 5-HT3 receptor lost positive modulation with 1 and 2 MAC of halothane. Most interestingly, positive modulation by halothane was converted into negative modulation in E106D mutant 5-HT3A receptor. CONCLUSIONS: The present study implicate the amino acid residues known for agonist binding and linking agonist binding to channel gating might also have important role for anesthetic modulation in 5-HT3A receptor.
Anesthetics ; Electrodes ; Electrophysiology ; Halothane ; Ligand-Gated Ion Channels ; Oocytes ; Patch-Clamp Techniques ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Xenopus laevis

41 cases of complicated cataract in leprosy patients were operated on from May 1989 to March 1990 at National Sorok Island Hospital. In all cases, extracapsular cataract extraction was attempted and sector or peripheral iridectomy was performed. Inferior sphincterotomy was not done in any of the cases. The postoperative results were very satisfactory in most of the operating cases. The results are as follows; 1) Corrected vision above 0.1 was obtained in 29 eyes(70.7%). 2) Corrected vision from F.C. to 0.09 was obtained in 8 eyes(19.5%). 3) Corrected vision below H.M. was obtained in 4 eyes(9.8%). 4) 37 eyes(90.2%) among the total 41 showed an improvement of corrected vision.
Cataract Extraction ; Cataract* ; Humans ; Iridectomy ; Leprosy*

Wegener's granulomatosis is characterized by necrotizing vasculitis and granuloma formation in both upper and lower respiratory tracts and in kidney. Other organs are also involved frequently. Ocular manifestations are Ehown in about 50% of patients with it. We experienced a case of Wegener's granulomatcsis developed prcgressive paranasal sinusitis and rhinitis combined with orbital and ocular involvement shown proptosis of both eyes, necrotic change of cornea and anterior portion of sclera in left eye and so forth. The diagnosis was confirmed by clinical findings and histopathologic features of tissue biopsy. The histopathology from periccular area of left eye had the typical findings of Wegener's granulomatosis with necrotizing vasculitis and granuloma formation. We had treated with oral cyclophosphamide(30~120mg/day) and corticosteroid(betamethaEcne 3mg 1M) and performed the enucleation of left eye due to widespread necrosis. The general condition and ocular findings were moderately improved with medical treatment but the eventual visual acuity was zero in right eye.
Biopsy ; Cornea ; Diagnosis ; Exophthalmos ; Granuloma ; Humans ; Kidney ; Necrosis ; Orbit ; Respiratory System ; Rhinitis ; Sclera ; Sinusitis ; Vasculitis ; Visual Acuity ; Wegener Granulomatosis*

Wegener's granulomatosis is characterized by necrotizing vasculitis and granuloma formation in both upper and lower respiratory tracts and in kidney. Other organs are also involved frequently. Ocular manifestations are Ehown in about 50% of patients with it. We experienced a case of Wegener's granulomatcsis developed prcgressive paranasal sinusitis and rhinitis combined with orbital and ocular involvement shown proptosis of both eyes, necrotic change of cornea and anterior portion of sclera in left eye and so forth. The diagnosis was confirmed by clinical findings and histopathologic features of tissue biopsy. The histopathology from periccular area of left eye had the typical findings of Wegener's granulomatosis with necrotizing vasculitis and granuloma formation. We had treated with oral cyclophosphamide(30~120mg/day) and corticosteroid(betamethaEcne 3mg 1M) and performed the enucleation of left eye due to widespread necrosis. The general condition and ocular findings were moderately improved with medical treatment but the eventual visual acuity was zero in right eye.
Biopsy ; Cornea ; Diagnosis ; Exophthalmos ; Granuloma ; Humans ; Kidney ; Necrosis ; Orbit ; Respiratory System ; Rhinitis ; Sclera ; Sinusitis ; Vasculitis ; Visual Acuity ; Wegener Granulomatosis*

To evaluate the effect of tibial cut with posterior slope in total knee arthroplasty(TKA) surgery on the flexion of the knee, 41 knees(32 patients) with varying degree of the posterior slope were retrospectively reviewed at more than 1 year after operation. Does sloping the tibial cut iurface rnore posteriorly promote increasing of maximal flexion of the knee by elimination of excessive tenaion of the posterior cruciate liga ment The degree of the posterior slope was radiographically measured, awi the change of the degree of the maximal flexion between preoperative and postoperative period was clinimlly measured with a goniometer at the latest follow up more than 1 year after operation. Comparison of the results demonstrated significantly larger degree of rqaximal flexion for the knees that had tibial cut with the degree of the posterior slope, 5 degrees or rnore (p<0.05). We concluded that 5 degrees or more posterior slope in proxirnal tibial cut is one of the important fact()r which could achieve increased flexion of the knee after TKA operation.
Arthroplasty* ; Follow-Up Studies ; Knee Joint ; Knee* ; Postoperative Period ; Retrospective Studies