No abstract available.
Masticatory Muscles* ; Trismus*

No abstract available.
Hematoma* ; Orbit*

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

This retrospective study was undertaken to provide information when considering aspects of future prevention and quantifying demand fir medical services. And it comprised 835 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Yeungnam University Hospital during the past five years from January 1991 to December 1996. The medical records of this 835 patients(1,210 fractures) were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic tendency. The following results were obtained; 1. The greatest number of patients were sustained facial bone injuries between midnight and 3:00. The monthly incidence showed in September at the most and at the least in December. The increase of facial bone injuries of 11.3% per year was shown. 2. The mean age of patients was 30 years. The most prevalent age group was at third decade(31.9%). Males were predominated more than female(3.6 : 1). 3. The most common cause was traffic accidents(41.6%) followed by violence, fall, industrial accidents and others. 4. The most common fracture was found in the nose(35.1%) followed by mandible(22.6%), zygoma(21.1%), and maxilla(11.2%). 5. Associated injuries were as following order of frequency; ophthalmologic injury(21.0%), other facial bone fractures(18.2%), head injury(10.2%). 6. Open reduction was used for 53.9% of total cases while 40.6% of total cases required closed reduction, and 5.5% of total cases treated conservatively. The complication rate was 18.5% and complications were as following order of frequency; facial asymmetry(37.2%), diplopia and enophthalmos(19.4%), and local infection(12.8%).
Accidents, Occupational ; Diplopia ; Facial Bones* ; Head ; Humans ; Incidence ; Male ; Medical Records ; Plastics ; Retrospective Studies ; Violence

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs

urpose: Misonidazole is a radiosensitizer that binds in hypoxic cells. The purpose of this study was to find out the feasibility of I-131-Iodomisonidazole (IMISO) for imaging of tumor hypoxia. MATERIALS AND METHODS: Tosyl precursor was dissolved in acetonitrile and I-131-NaI was added to synthesize IMISO. Balb/c mice inoculated with CT-26 adenocarcinoma were injected with IMISO. Mice were sacrificed at 1,2,4,24 hr and % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy and MRI, mouse bearing CT-26 adenocarcinoma was administered with IMISO and imaging was performed 4 hr after. Then, mouse body was fixed and microtomized slice was placed on radiographic film for autoradiography. RESULTS: %ID/g of tumor was 1.64 (1h), 0.98 (2h), 0.85 (4h) and 0.20 (24h), respectively. At 24h, %ID/g of tumor was higher than that of all other tissues except thyroid. Tumor to muscle ratio increased with time and tumor to blood ratio also increased with time and reached 1.53 at 24 hr. On autoradiogram, tumor was well visualized as an increased activity in central hypoxic area of the tumor which corresponds to the area of high signal intensity on T2-weighted MR image. On scintigraphy, tumor uptake was visualized. CONCLUSION:: This RESULTS suggest that IMISO may have a potential for tumor hypoxia imaging in mouse model. However, further study is needed to improve it's localization in tumor tissue and to achieve acceptable images of tumor hypoxia.
Adenocarcinoma* ; Animals ; Anoxia* ; Autoradiography ; Magnetic Resonance Imaging ; Mice* ; Misonidazole ; Radionuclide Imaging ; Thyroid Gland ; X-Ray Film

PURPOSE: The aim of this study was to assess the effectiveness, survival rate and complications of radiation therapy and chemoradiation treatment in hypopharyngeal cancer. METHODS AND MATERIALS: From January 1984 to December 1999, 56 patients who had hypopharyngeal carcinoma treated with curative radiation therapy were retrospectively studied. Twenty four patients (42.9%) were treated with radiation therapy alone (Group I) and 32 (57.1%) treated with a combination of chemotherapy and radiation (Group II). Total radiation dose ranged from 40.5 to 83. 5 Gy (median 67.9 Gy). Radiotherapy was given with conventional technique in 9 patients (16.4%), with hyperfractionation I (1.15~1.2 Gy/fr., BID) in 26 (47.2%), hyperfractionation II (1.35 Gy/fr., BID) in 18 (32.7%), and accelerated fractionation (1.6 Gy/fr., BID) in 2 (3.6%). In chemotherapy, 5-FU (1,000 mg/m2 daily for 5 consecutive days) and cisplatin (100 mg/m2 on day 1) were administered in a cycle of 3 weeks interval, and a total of 1 to 3 cycles (average 2..3 cycles) were given prior to radiation therapy. Follow up duration was 1~195 months (median 28 months). RESULTS: Overall 2 and 5 year survival rates were 40.6% and 27.6%; 50.0% and 30.0% in Group I, and 36.4% and 26.3% in Group II, respectively. Complete local control rates in Group I and II were 70.0% and 67.7%, respectively. The response to radiotherapy and nodal stage were statistically significant prognostic factors. The complication rate was increased in Group II and was decreased in hyperfractionation. CONCLUSION: The response to radiotherapy and nodal stage were valid factors to indicate the degree of control over the hypopharyngeal cancer. The induction cisplatin, 5-Fu chemotherapy was not valid in terms of local control rate and survival rate, but did contribute to an increased complication rate. The use of hyperfractionation was valid to reduce the late radiation complications.
Cisplatin ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Hypopharyngeal Neoplasms* ; Radiotherapy* ; Retrospective Studies ; Survival Rate

Relapsing polychondritis is an uncommon disease manifested by episodes of progressive inflammation and destruction of cartilage. While the cause remains unknown, an autoimmune pathogenesis appears likely. Characteristic features include auricular chondritis, arthritis, nasal chondritis, ocular inflammation, respiratory tract involvement and audiovestibular damage. The clinical course of patients may vary from a relatively benign illness free of clinically evident visceral involvement, to one of episodic or smoldering activity with variable intensity, to a f ulminant illness and death within months of diagnosis. Dapsone, corticosteroid and immunosuppressive agent remain the effective therapies. We have experienced a case of relapsing polychondritis and active pulmonary tuberculosis in a 69-year-old man. He suffered from arthralgia and swelling of joints for several months on the first admission and initially was diagnosed as pseudogout based on polyarthritis and chondrocalcinosis of right knee joint. During follow-up, chondritis of both auricles and nose, which was proved by the biosy of right auricle, and relapse of polyarthritis were developed. His spu tum smear for acid-fast bacillus was postive on the second admission. Then he was diagnosed as relapsing polychondritis and active pulmonary tuberculosis and has achieved improvement with medication of dapsone and antituberculosis drugs according to susceptability test during followed-up. Thus we report this case with literature review.
Aged ; Arthralgia ; Arthritis ; Bacillus ; Cartilage ; Chondrocalcinosis ; Dapsone ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Joints ; Knee Joint ; Nose ; Polychondritis, Relapsing* ; Recurrence ; Respiratory System ; Tuberculosis, Pulmonary

BACKGROUND: To investigate the mechanisms of myocardial ischemia induced changes of electrophysiological properties, influences of various ischemic-simulated Tyrode's solutions on the changes of action potential characteristics were examined. METHOD: Action potential characteristics were measured during superfusion with various ischemic-simulated solutions (modified physiologic salt solution: MPSS) by the method of conventional microelectrode technique in rat atrial fibers. RESULTS: Hypoxic-, hyperkalemic-, and mixed-MPSS decreased 'maximum diastolic potential' (MDP) and 'action potential amplitude' (APA), however, no significant changes of MDP and APA were observed by acidic- and glucose-free-MPSS. 'Maximum velocity of phase 0 depolarization' (dV/dt(max)) and 'time for 90% repolarization' (APD90) significantly decreased during hypoxic- and mixed-MPSS superfusion, and hyperkalemic-MPSS also decreased the dV/dt(max) and APD90. However, no significant changes in dV/dt(max) and APD90 were observed by acidic- and glucose-free-MPSS. The decreasing effects of dV/dt(max) and APD90 by the MPSSes were attenuated when the MPSSes were replaced with normal Tyrode's solution. DPCPX (2x10(-6)M), a purinergic antagonist, inhibited the decreasing effects of APD90 at 5, 10, and 20 min superfusion of the mixed-MPSS, and glibenclamide (10(-6)M), a K(ATP) channel blocker, inhibited those at 10 and 20 min superfusion of the mixed-MPSS. Diclofenac (10(-6)M), a cyclooxygenase inhibitor inhibited only those at 20 min superfusion of the mixed-MPSS. CONCLUSION: The primary factors for changing the electrophysiological characteristics during ischemic insults could be hypoxia and high-extracellular K+, and the mechanisms of the electrophysiological changes are inferred that adenosine through purinoceptors is involved initially, and followed by K(ATP) channel and prostanoids.
Action Potentials* ; Adenosine ; Animals ; Anoxia ; Diclofenac ; Glyburide ; Ischemia ; Microelectrodes ; Myocardial Ischemia ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Rats* ; Receptors, Purinergic

BACKGROUND: Nitrovasodilators are known to induce hypotension through activating nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway. By inhibiting the breakdown of cGMP, sildenafil citrate may augment the nitrovasodilator-induced hypotension. The present study was aimed to investigate whether sildenafil would reduce the dose of nitrovasodilators needed to induce the hypotension. METHODS: Ten mongrel dogs were acutely instrumented with a femoral artery catheter and a pulmonary artery catheter. They were intravenously given sodium nitroprusside (SNP; 1-16ng/kg/min) or nitroglycerin (NTG; 2 - 32ng/kg/min) to induce hypotension. The study was composed of two occasions in each animal: one with sildenafil pretreatment (1 mg/kg IV followed by 0.3 mg/kg/h) and the other without to serve as control, one week apart. Hemodynamic parameters were continuously monitored. Plasma cGMP concentrations were measured by radioimmunoassay. RESULTS: Both SNP and NTG produced dose-dependent reductions in mean arterial pressure (MAP) without affecting the heart rate in both the control and sildenafil groups. Systemic vascular resistance index (SVRI) and mean pulmonary arterial pressure were also decreased. However, SNP caused a greater reduction of MAP and SVRI in the sildenafil group than in the control group; whereas, NTP caused similar reductions in both groups. Neither SNP nor NTG altered the plasma cGMP concentrations. Sildenafil increased the plasma cGMP concentration, which was further increased by SNP, but not by NTG. CONCLUSIONS: These results indicate that sildenafil may reduce the dose of SNP, but not that of NTG needed to produce hypotension in the dog. The potentiation of SNP-induced hypotension by sildenafil may be related to an augmented cGMP effect.
Animals ; Arterial Pressure ; Catheters ; Citric Acid* ; Dogs* ; Femoral Artery ; Guanosine Monophosphate ; Heart Rate ; Hemodynamics ; Hypotension* ; Nitric Oxide ; Nitroglycerin ; Nitroprusside* ; Plasma ; Pulmonary Artery ; Radioimmunoassay ; Sodium* ; Vascular Resistance ; Sildenafil Citrate