PURPOSE: To evaluate the clinical results of 6 mm iris-fixated phakic intraocular lens (Artisan(R) lens) implantation in myopic patients. METHODS: Forty eyes of 23 myopic patients underwent 6-mm Artisan(R) phakic IOL implantation and were followed-up for over 6 months. We prospectively analyzed the efficacy, stability, predictability, change of astigmatism, endothelial cell count, pupil diameter, degree of decentration, subjective satisfaction and complications. RESULTS: The preoperative mean spherical equivalent was -9.46 D, and postoperative spherical equivalent was -0.70D at 1 month, -0.55D at 3 months, -0.54D at 6 months, -0.78D at 12 months and remained stable during the follow-up period. The preoperative mean astigmatism was -1.88D and postoperative astigmatism was -0.87D at 6 months. Postoperative uncorrected visual acuity (UCVA) was more than 0.8 in 85% of the eyes at 1 month, 91% at 3 months, 95% at 6 months, and 89% at 12 months. The spherical equivalent refraction after surgery was within 1.0D of emmetropia in 78% of eyes at 1 month, 80% at 3 months, 88% at 6 months, and 64% at 12 months. There was no significant decrease in the endothelial cell count during the follow-up period. Preoperative scotopic pupil diameters were significantly decreased at 1 month and the mean decentration of the lens was 0.38 mm. Patient satisfaction was generally high. Complications included the transient elevation of intraocular pressure in 1 eye, corneal edema in 4 eyes, iritis in 1 eye, traumatic dislocation in 1 eye and iris atrophy in 2 eyes. CONCLUSIONS: The 6-mm Artisan(R)phakic IOL implantation may be an effective surgical procedure for myopic patients who cannot undergo corneal refractive surgery, as it provided good visual results, predictability, patient satisfaction, and short-term safety.
Astigmatism ; Atrophy ; Corneal Edema ; Dislocations ; Emmetropia ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Iris ; Iritis ; Patient Satisfaction ; Phakic Intraocular Lenses ; Prospective Studies ; Pupil ; Refractive Surgical Procedures ; Visual Acuity

PURPOSE: The purpose of this study was to establish optimal imaging acquisition conditions for the GE Advance(TM) PET imaging system by performing the acceptance tests designed by National Electrical Manufacturers Association (NEMA) protocol and General Electric Medical Systems (GEMS) test procedures. MATERIALS AND METHODS: Performance tests were carried out with 18FDG radioactivity source and phantoms by using a standard acquisition mode. Transaxial resolution and scatter fraction tests were performed with a line source and axial resolution with a point source, respectively. A cylindrical phantom made of polymethylmethacrylate (PMMA) was used to measure sensitivity, count rate losses and randoms, uniformity correction, and attenuation inserts were added to measure remaining tests. The test results were acquired in a diagnostic acquisition mode and analyzed mainly on high sensitivity mode. RESULTS: Transaxial resolution and axial resolution were measured as average of 4.65 mm and 3.98 mm at 0 cm, and 6.02 mm and 6.71 mm at 20 cm on high sensitivity mode, respectively. Average scatter fraction was 9.87%, and sensitivity was 225.8 kcps/micronCi/cc of trues. Activity at 50% deadtime was 4.6 Ci/cc, and the error of count rate correction at that activity was from 1.49% to 3.83%. Average nonuniformity for total slice was 8.37%. The accuracy of scatter correction was -0.95%. The accuracies of attenuation correction were 5.68% for air, 0.04% for water and -6.51% for polytetrafluoroethylene (PTFE). CONCLUSION: The results satisfied most acceptance criteria, indicating that the GE AdvanceTM PET system can be optimally used for clinical applications.
Electrons* ; Fluorodeoxyglucose F18 ; Polymethyl Methacrylate ; Polytetrafluoroethylene ; Positron-Emission Tomography* ; Radioactivity ; Water

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

PURPOSE: Abutted scatter energy windows used for a triple energy window (TEW) method may provide wrong estimation of scatter. This study is to propose an extended TEW (ETEW) method, which doesn't require abutted scatter energy windows and overcomes the shortcomings of TEW method. MATERIALS AND METHODS: The ETEW is a modification of the TEW which corrects for scatter by using abutted scatter rejection windows, which can overestimate or underestimate scatter. The ETEW is compared to the TEW using Monte Carlo simulated data for point sources as well as hot and cold spheres in a cylindrical water phantom. Various main energy window widths (10 %, 15 % and 20 %) were simulated. Both TEW and ETEW improved image contrast, % recovery coefficients and normalized standard deviation. RESULTS: Both of TEW and ETEW improved image contrast and % recovery coefficients. Estimated scatter components by the TEW were not proportional to the true scatter components over the main energy windows when ones of 10 %, 15 %, and 20 % were simulated. The ETEW linearly estimated scatter components over the width of the main energy windows. CONCLUSION: We extended the TEW method into the method which could linearly estimate scatter components over the main energy windows.
Tomography, Emission-Computed, Single-Photon* ; Water

Various symptoms, such as bradycardia, hypotension, fatigue, constipation, myalgia, muscle weakness, delayed tendon reflex, and so forth, presented in hypothyroidism. Of these symptoms, muscle weakness, myalgia, and delayed tendon reflex are common features of hypothyroid myopathy. Acute rhabdomyolysis, a very severe form of myopathy, but is a rare manifestation of primary hypothyrodism. A 29-year-old man developed acute rhabdomyolysis, associated with primary hypothyroidism as a first manifestation. After thyroxine replacement therapy, he exhibited some improvement in muscle weakness and in non-pitting edema. We report a case of primary hypothyroidism presenting with spontaneous rhabdomyolysis as a first manifestation.
Adult ; Bradycardia ; Constipation ; Edema ; Fatigue ; Humans ; Hypotension ; Hypothyroidism* ; Muscle Weakness ; Muscular Diseases ; Myalgia ; Reflex, Stretch ; Rhabdomyolysis* ; Thyroxine

BACKGROUND: Recently, in our ageing society, the change in dietary pattern and increase in obesity have caused the metabolic syndrome to increase in Korea. Because of the association of the risk of cardiovascular diseases, the metabolic syndrome must be prevented and well managed. We examined the association between the metabolic syndrome and the serum testosterone and DHEA-S concentration. METHODS: The subject of this study included 231 men aged more than 40 years old who visited the health promotion center of a university hospital from March 2004 to March 2006. We excluded the subjects who were currently on medications except for antihypertensive and hypoglycemic agents. We defined the metabolic syndrome according to the ATP III with Asia-Pacific waist circumference. To examine the association between the metabolic syndrome and the serum testosterone concentration, we used the method of multiple logistic regression analysis. RESULTS: The prevalence of the metabolic syndrome in our subjects was 32.9%. Decreased serum testosterone concentration was significantly associated with large waist circumference and high fasting blood sugar. Men with testosterone values in the upper tertile had a significantly lower risk of metabolic syndrome (OR=0.34, P=0.018). CONCLUSION: After statistical adjustment for age, smoking, income, exercise, alcohol intake, and body mass index, the serum testosterone concentration was negatively associated with the metabolic syndrome.
Adenosine Triphosphate ; Adult ; Blood Glucose ; Body Mass Index ; Cardiovascular Diseases ; Fasting ; Health Promotion ; Humans ; Hypoglycemic Agents ; Korea ; Logistic Models ; Male ; Obesity ; Prevalence ; Smoke ; Smoking ; Testosterone* ; Waist Circumference

BACKGROUND: This study was conducted to investigate risk factors for perioperative periods between general anesthesia (GA group) and thoracic epidural blockade combined with general anesthesia (CEA group) for consecutive hepatic resections. METHODS: A retrospective chart review was carried out regarding 85 patients who had undergone hepatic resections. We compared the effects of postoperative pain control in the two groups, including pulmonary complications and durations of hospital stay. RESULTS: There was no significant difference in demographic data between the two groups. The perioperative fluid requirement and transfusions were lower in the CEA group. Supplemental analgesics requirement was significantly lower in the CEA group than the GA group in the 3 days postoperatively. There were no statistical difference between the two groups in nausea, vomiting, urticaria, constipation or urinary retention, but hypotension was more pronounced in the CEA group than the GA group. Postoperative pulmonary and surgical complications were similar between the two groups, but the duration of hospital stay was longer in the GA group than the CEA group. CONCLUSIONS: We conclude that the thoracic epidural blockade combined with general anesthesia provided lower surgical blood loss and better postoperative analgesia and hospital stay than general anesthesia for hepatic resections.
Analgesia ; Analgesics ; Anesthesia, General* ; Blood Loss, Surgical ; Constipation ; Hepatectomy* ; Humans ; Hypotension ; Length of Stay ; Nausea ; Pain, Postoperative ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Urinary Retention ; Urticaria ; Vomiting

BACKGROUND: Compared to inhalation and local anesthetics, little is known about the mechanisms of vascular effects of intravenous anesthetics. So we studied the effects of thiopental sodium, midazolam, propofol and ketamine on the endothelial nitric oxide-cGMP pathway and also on the membrane cyclooxygenase pathway. METHODS: After isolating ring strips of rat thoracic aorta, we measured the relaxation ED50 values of the four intravenous anesthetics from the maximally contracted using phenylephrine 10(-5)M. Then using L-NAME and methylene blue, we studied the effects of the drugs upon the NO-cGMP system. In addition, another pathway of vasodilation through membrane prostaglandin metabolism was examined using the membrane cyclooxygenase inhibitor, indomethacine. RESULTS: The following results were obtained. 1. Thiopental sodium (10(-5)M) did not have any effect on the PE induced contractions of aortic rings but midazolam (10(-6)M), propofol (10(-4)M) and ketamine (10(-3)M) significantly (P < 0.05) inhibited the PE induced contractions of aortic rings. 2. Midazolam 10(-6)M and propofol 10(-4)M induced relaxation of aortic rings were recovered with L-NAME pretreatment but ketamine induced relaxation was not recovered with L-NAME. 3. Midazolam 10(-6)M induced relaxation was not recovered with methylene blue pretreatment, but propofol 10(-4)M induced relaxation was recovered with methylene blue. 4. Indomethacine pretreatment induced further relaxation of midazolam or propofol induced relaxation of aortic rings. CONCLUSIONS: Midazolam, propofol and ketamine, but not thiopental sodium, relax rat thoracic aortic rings, and these relaxation effects of midazolam and propofol are endothelium dependent. Cyclooxygenase inhibition is related at least in part to midazolam or propofol induced relaxation, and guanylate cyclase to propofol induced relaxation.
Anesthetics, Intravenous ; Anesthetics, Local ; Animals ; Aorta, Thoracic ; Endothelium ; Guanylate Cyclase ; Indomethacin ; Inhalation ; Ketamine* ; Membranes ; Metabolism ; Methylene Blue ; Midazolam* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Phenylephrine ; Propofol* ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Relaxation ; Thiopental* ; Vasodilation

Acute mesenteric infarction is a catastrophic illness representing a diverse spectrum of pathologic conditions which ultimately lead to necrosis of the intestine and which is uniformly fatal if left untreated. Despite better understanding of the disease process, acute mesenteric infarction continues to be a lethal disorder with high mortality rate. We experienced two cases of acute mesenteric infarction due to superior mesenteric arterial and venous branch occlusion, respectively, in recent years: One case was focal segmental ischemia with normal radiologic finding including angiography, successfully treated with segmental resection of the necrotized ileum, another case was mesenteric venous thrombosis, also treated with resection of necrotized small intestine followed by second look operation.
Angiography ; Catastrophic Illness ; Ileum ; Infarction* ; Intestine, Small ; Intestines ; Ischemia ; Mortality ; Necrosis ; Venous Thrombosis

The left parasternal impulse was evaluated by inspection and palpation, and it's contour was confirmed with graphic display using a pilse pickup in 45 normal subjects and 33 patients with various cardiac disease.Using an upper limit of normal echocardiographic LV end-diastolic dimension insides, 3.7cm/m2, LV mass index, 80g/m2, RV dimension index, 2.9cm/m2, and RV free wall thickness, 0.4cm, the patients were subdivided into four groups. In 9 patients with pure RV hypertrophy or dilation, the hyperdynamic impulse or sustained heave was noticed in 7 cases(sensitivity 78%, specificity 76%). In 12 patients with pure LV hypertrophy or dilation, striking parasternal systolic retraction was noticed in 5 cases(sensitivity 42%, speccificity 86%). But in 7 patient with biventricular hypertrophy or dilation, either striking systolic retraction or hyperdynamic impulse was noticed in 4 cases. These findings suggest that the evaluation of the parasternal movement is helpful for the cardiac examination.
Echocardiography ; Humans ; Hypertrophy ; Palpation ; Sensitivity and Specificity ; Strikes, Employee