The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.
Adult ; Animals ; Biopsy ; Female ; Flank Pain ; Horns ; Humans ; Kidney Pelvis ; Low Back Pain ; Lower Extremity ; Melanoma ; Neoplasm Metastasis ; Nevus ; Physical Examination ; Sacrum ; Spine ; Spondylolisthesis

The tension lowering effects of Diamox and other carbonic anhydrase inhibitors are well known and they are widely used against a various forms of glaucomas. This paper deals with the clinical experiences in normal and glaucomatous human eyes with Diamox-Sequels, kindly supplied by Lederle Laboratories and Yuhan Corp. MATERIALS AND METHODS: Normal healthy persons, 15 females and 20 males, were studied on their 45 eyes. Glaucomatous disease had been ruled out by careful examinations of intraocular pressure, visual fields and fundus. They had been also checked for the diurnal variations of intraocular pressure during the daytime. One capsule (500mg) of Diamox Sequels was given to each individual and the changes in the intraocular pressure were studied at various time intervals up to 53 hours after the administration. Tonometry was carried out by the Goldmann's applanation tonometer. The effects of Diamox Sequels on the glaucomatous eyes were studied in the same way. The glaucomatous eyes included 10 eyes of 7 chronic simple glaucoma patients, 5 eyes of 3 chronic narrow-angle glaucoma patients and 5 eyes of 5 secondary glaucoma subjects. They received one capsule of Diamox Sequels and the intraocular pressure was measured one or two times daily. The results of long-term treatment were also studied by daily administration of one capsule of Diamox Sequels, follow-up periods being from 3 to 19 days. No medication, oral or local, of antiglaucomatous drugs were allowed for at least 3 days prior to this study. The differences due to age, sex and type of glaucoma were not considered here. At the same time, the effects of a single 500mg of ordinary Diamox tablet were studied in normal ~md glaucomatous eyes. RESULTS: (1) Normal eyes. The intraocular pressure began to fall 1 hour after the administration. The tension gradually fell and the maximal reduction of tension occurred after 9.8 hours and the extent of maximal fall was 4.5mm Hg on the average, 29.4 % of the original intraocular pressure. The tension gradually rose and returned to the original level between 23~50 hours (average 43 hours). Side effects were noted in 4 cases, e.g., 11.4 %. (2) Glaucomatous eyes. The effects were noted within the first 1~2 hours and became maximal after 13 hours, the extent of the maximal fall 40.1 % of the original pressure, e.g., 16.2 mmHg. The original tension was restored after 30 hours. By long-term administration of Diamox Sequels, 8 eyes(40 %) showed excellent results, their intraocular pressure maintained below 21 mmHg. Sede-effects were noted in 3 cases(20.0 %). COMMENTS: The effects of Diamox Sequels and Diamox tablet on normal and glaucomatous subjects were summarized in table 1. As shown, Diamox Sequels has the longer duration of hypotensive actions and the time of maximal fall of intraocular pressure delayed considerably, as compared with Diamox tablet. In almost all cases, its action continued for more than 24 hours. In glaucomatous eyes, the time of maximal reduction of ocular tension was slightly later and the maintenance of low tension was slightly shorter than those in normal eyes. The extent of the maximal fall, however, was almost the same after administration of Diamox Sequels and Diamox. Side effects were encountered in 11~20% of cases by Diamox Sequels, and in 40-60% of cases by Diamox. This is one of the most striking advantages of Diamox Sequels over Diamox. Thus it is concluded that Diamox Sequels has the longer hypotensive actions and fewer side effects.
Acetazolamide* ; Carbonic Anhydrase Inhibitors ; Female ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Male ; Manometry ; Strikes, Employee ; Visual Fields

Authors experienced 100 cases of retrobulbar optic neuritis among the patients who visited the Chang Shoo Choi Eye Clinic during the last 2 years, from September 1, 1964 to August 31, 1966. The chief complaints are asthenopia, blurring vision, ocular pain, headache and photophobia. Of 100 cases, 46 cases wanted to be refracted. The corrected visual acuities are not always poor, though they are very variable from time to time as the tests are processing. The most cases revealed central relative scotomas instead of cecocentrals as previously believed. Fields are taken with glasses if corrected. In our cases, the age distribution of the patients are very interesting, the most susceptible age groups are 11~13 years.
Age Distribution ; Asthenopia ; Eyeglasses ; Glass ; Headache ; Humans ; Optic Neuritis* ; Photophobia ; Scotoma ; Vision, Ocular ; Visual Acuity

BACKGROUND: The afferent and efferent pathways of fentanyl cough response (FCR) and central organization are poorly understood at present. The aim of this study was to investigate the pretreatment effects of morphine, propofol, atropine, and midazolam on FCR. METHOD: The 120 healthy patients were randomly assigned to six equal pretreatment groups. They received 2ug/kg fentanyl rapidly through a peripheral venous catheter. The patients in each group were pretreated before the time necessary for peak plasma levels with different drugs as follows: group 1, no premedication; group 2, morphine 0.05 mg/kg iv; group 3, morphine 0.05 mg/kg iv naloxone 0.01mg/kg iv; group 4, propofol 0.5 mg/kg iv; group 5, atropine 0.01 mg/kg iv; group 6, midazolam 0.05 mg/kg iv. The patients were observed for any coughing or side effects, including oxygen desaturation, bronchoconstriction, chest wall rigidity and seizure. RESULT: 40% of patients in group 1 (control) had a cough response to fentanyl. Group 2 (morphine) and group 3 (morphine naloxone) showed a reduced FCR of 10%. The incidence of coughing was 60% of the patients in group 4 (propofol), 30% in group 5 (atropine), and 40% in group 6 (midazolam). These were not statistically significant. CONCLUSION: FCR is not altered by pretreatment with propofol, atropine, or midazolam, but morphine inhibits cough response and this antitussive effect was not antagonized by naloxone.
Atropine* ; Bronchoconstriction ; Catheters ; Cough* ; Efferent Pathways ; Fentanyl* ; Humans ; Incidence ; Midazolam* ; Morphine* ; Naloxone ; Oxygen ; Plasma ; Premedication ; Propofol* ; Seizures ; Thoracic Wall

This study reports the influence of miotics (pilocarpine) on the visual field by comparing two visual fields, one at the miotic state and the other at normal pupil size. The measurements from the Goldmann perimetry test of 10 ocular hypertensive eyes (7 patients) and 10 glaucomatous eyes (8 patients) were used. The visual field was analyzed using an Esterman grid for functional estimation and section paper for gross evaluation. The results were as follows; 1. A decrease in pupillary size eaused not only a decrease in the gross visual field but also a reduction in the functional visual field. 2. The pupillary size did not influence absolute scotoma.
Glaucoma/drug therapy ; Humans ; Pilocarpine/*pharmacology/therapeutic use ; Visual Fields/*drug effects

PURPOSE: The purpose of this study was to investigate the relationships among variables of somatic attribution, chronic pain, depression and chronic fatigue in the elderly. METHODS: Empirical data for testing hypothetical models was collected from 311 people over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explained causal relationship of variables. RESULT: According to Accepted model, the relation of variables is that the somatic attribution is the influencing variable to chronic pain and depression and chronic pain and depression is the influencing variable to chronic fatigue. CONCLUSION: The findings of this study give useful information to construct intervention program relating chronic pain, depression and chronic fatigue for the elderly.

This analysis describes the influence of miotics (pilocarpine) on the visual field obtained from the Goldmann perimetry testing of 10 ocular hypertensive eyes (7 patients) and 10 glaucomatous eyes (8 patients) by comparison of two visual fields testing at miotic state and at normal pupil size. The analysis of visual field was done by Esterman grid for functional estimation and by section paper for gross evaluation. The results were as follows; 1. Decreased pupillary size caused not only the decrease of the gross visual field but also the decrease of the functional visual field. 2. Absolute scotoma was not influenced by the pupillary size.
Glaucoma* ; Miotics* ; Pupil ; Scotoma ; Visual Field Tests ; Visual Fields*

In order to assess a possible damage to the corneal endothelium by the increased intraocular pressure, we investigated the 8 eyes of angle closure glaucoma, 10 eyes of ocular hypertension, 20 eyes of primary open angle glaucoma, and 15 normal eyes as a control group. We photographed the central corneal endothelium with a non contact specular microscope and measured the central corneal thickness three times with a Haag-Streit pachymeter. As compared to the normal eyes the glaucomatous eyes and ocular hypertensive eyes showed a statistically significant decrease of central corneal endothelial cell density(p<0.005), but in central corneal thickness there was no statistically significant difference between two. There was a reverse correlation between the intraocular pressure and the central corneal endothelial cell density(p<0.05), but no correlations were seen between the intraocular pressure and the central corneal thickness and between the central corneal endothelial cell density and the central corneal thickness(p>0.1).
Endothelial Cells* ; Endothelium, Corneal ; Glaucoma* ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Intraocular Pressure ; Ocular Hypertension*

Alpha-chymotrypsin solutions, 200 unit/ml and 1,000 unit/ml, were injected into the anterior chamber of albino rabbit eyes fonowed by irrigation with normal saline after 3 minutes. Intraocular pressure was recorded by pressure transducer and pressure decay curve analysis was made to calculate the outflow facility according to the method of Eisenlohr and Langham. The follow-up periods were 30 days after the injection of the enzyme solution. By the injection of 0.25 ml of 200 unit/ml solution in 7 eyes, intraocular pressure showed almost no changes throughout the observation period. Outflow facility showed transient decrease during the first 3 to 5 days in some eyes. After the injection of 0.25 ml of 1,000 unit/ml solution in 3 eyes, transient elevation of the intraocular pressure was noted associated with decrease in outflow facility. In one eye, a marked rise in ocular pressure was found All the changes in intraocular pressure and outflow facility returned to the pre-treatment level within 30 days. It was concluded that high concentration of the alpha-chymotrypsin solution injected into the anterior chamber might cause disturbances in trabecular function causing elevation in intraocular pressure.
Anterior Chamber ; Follow-Up Studies ; Intraocular Pressure ; Transducers, Pressure

No abstract available.