Amidarone hydrochloride, benzofuran derivatives, particularly effective for the treatment of arrythmias by prolong the duration of the action potential in all cardiac-conducting tissues. We studied the 25 patients with typical amiodarone keratopathy, retrospectively. In 25 patients, ten patients developed grade 1, eleven patients developed grade 2, and four patients developed grade 3 keratopathy. They complained of decreased best corrected visual acuity(1 patient), halos(1 patient), hypothyroidism(3 patients), pulmonary toxicity(2 patients), thpatic dysfunction(5 patients) and sleep dusturbance(3 patients). Therefore ophthalmologists should be alert for the complications of amiodarone and regular careful slit-lamp examination will be helpful in minimizing amidarone toxicity.
Action Potentials ; Amiodarone* ; Arrhythmias, Cardiac ; Humans ; Retrospective Studies

BACKGROUND: Vasoconstrictors have been used as an adjunct to local anesthetics to prolong the duration of spinal anesthesia. Recently, clonidine, an 2-receptor agonist has been shown to prolong the duration of spinal anesthesia following intrathecal administration. Bupivacaine has been used for spinal anesthesia and compared with tetracaine in recent studies. We have undertaken this study to further evaluate the effect of clonidine in hyperbaric 0.5% bupivacaine spinal anesthesia. METHODS: Thirty patients who were scheduled for lower limb or urologic operation were divided into 2 groups: Group A (hyperbaric bupivacaine 13 mg, 2.6 ml + N/S 1 ml), Group B (hyperbaric bupivacaine 13 mg, 2.6 ml + clonidine 150 g, 1 ml). We used standardized techniques and injected above drugs to group A and B intrathecally for spinal anesthesia. We investigated the onset and the duration of spinal anesthesia along with hemodynamic changes (blood pressure and heart rate) in patients. RESULTS: There were no significant differences in the onset of spinal anesthesia and hemodynamic changes between two groups. The time taken to recover from the nerve block was more prolonged in the group B (touch 225, pain 262, foot dorsiflexion 271, knee flexion 290 minutes) than group A (touch 154, pain 188, foot dorsiflexion 198, knee flexion 216 minutes). There were no significant differences in sedation, and in experiencing dry mouth and other side effects between two groups. CONCLUSION: Intrathecal clonidine 150 g has been proved to prolong the duration of hyperbaric 0.5% bupivacaine spinal anesthesia without neurotoxicity or dangerous hemodynamic depression. Therefore, clonidine can be used as an effective adjunct in hyperbaric bupivacaine spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Clonidine* ; Depression ; Foot ; Heart ; Hemodynamics ; Humans ; Knee ; Lower Extremity ; Mouth ; Nerve Block ; Tetracaine ; Vasoconstrictor Agents

No abstract available.
Adult* ; Humans ; Neck*

PURPOSE: The prognosis after potentially curative resection for stage IV gastric cancer, according to the 5th edition of AJCC/UICC classification, is poorly understood. The aim of this study was to evaluate the feasibility of the curative resection in patients with stage IV gastric cancer, which were considered potentially curable cases. METHODS: From November 1991 to June 1996, 91 patients were confirmed as having stage IV gastric cancer at Seoul Boramae Municipal Hospital. Of these 91 patients, 30 who were potentially curative resected including at least D2 type lymph node dissections were reviewed retrospectively. The average numbers of totally dissected and positive lymph nodes were 43.0 (range: 26~74) and 23.1 (range: 2~47), respectively. RESULTS: The overall 1-, 2-, and 5-year survival rates of patients were 60.0%, 36.7%, 13.3%, respectively. In comparison with stage IIIb (N=20), no significant difference in survival rate was observed (P=0.1178). In univariate analysis, we found that the presence of a recurrence (P=0.0121) and a P (positive lymph nodes)/R (total dissected lymph nodes) >0.6 were correlated with poor survival rates. Long- survivors (N=12, more than 24 months postoperatively) had a tendency to be younger, less recurrent (P=0.017) and less involvement of histological perineural invasion (P=0.028). CONCLUSION: The results of the present study indicate that stage IV patients without distant metastasis may indeed be cured by potentially curative surgery.
Classification* ; Gastrectomy* ; Hospitals, Municipal ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Stomach Neoplasms* ; Stomach* ; Survival Rate ; Survivors

Carcinoid tumors are slow growing neoplasms that arise from enterochromaffin cells, with malignant potential, and those of the duodenum are rare neoplasms, with an incidence of 2.0~8.9% of all gastrointestinal carcinoid tumors. Duodenal carcinoid tumors rarely manifest gastrointestinal symptoms and carcinoid syndrome. A healthy 43 year old woman was admitted due to an incidentally detected duodenal mass during regular health screening. An abdominal CT scan and UGI series showed a polypoid mass at the second portion of the duodenum without bowel dilatation. The duodenoscopic finding was a carcinoid tumor, which was proven by immunohistochemical staining. A pylorus- preserving pancreatoduodenectomy was performed and a 2.5x2.2 cm sized submucosal tumor found at the second portion of the duodenum, with two periduodenal lymph node enlargements. Immunohistochemical staining showed that the tumor cells to have positive reaction for NSE, chromogranin and synaptophysin. Herein, our experience of a malignant duodenal carcinoid tumor is reported.
Adult ; Carcinoid Tumor* ; Dilatation ; Duodenum ; Enterochromaffin Cells ; Female ; Humans ; Incidence ; Lymph Nodes ; Mass Screening ; Pancreaticoduodenectomy ; Synaptophysin ; Tomography, X-Ray Computed

Splenic metastasis resulting from solid tumors is a rare event, and it is most often diagnosed at the time of autopsy. In those cases of widely disseminated cancer, splenic involvement may be fairly common, but solitary splenic metastasis in the absence of other metastases is exceedingly rare. The reported primary malignancies of patients with splenic metastases include lung, colorectal, endometrial, ovarian, thyroid, pancreatic, gastric cancers and most commonly, melanoma. The author report here on a case of 55- year-old male who was found to have a solitary splenic metastasis 12 months after undergoing a left upper lobectomy for stage Ib (pT2N0M0) adenocarcinoma of the lung and he was then treated by splenectomy.
Adenocarcinoma ; Autopsy ; Humans ; Lung Neoplasms ; Lung* ; Male ; Melanoma ; Neoplasm Metastasis* ; Splenectomy ; Splenic Neoplasms ; Stomach Neoplasms ; Thyroid Gland

Photodynamic therapy (PDT) can be used as palliative therapy to reduce obstructive symptoms in patients with advanced lung cancer. Herein, we report on the case of a patient with fatal broncho-mediastinal fistula after PDT. A 57-year-old woman was diagnosed as non-small cell lung cancer (squamous cell carcinoma, cT4N3). She received PDT on the endobronchial mass obstructing her right main bronchus twice in 48 hours interval. Two weeks later, concurrent chemoradiation therapy (CCRT) with weekly Paclitaxel/Carboplatin was started. During maintenance chemotherapy, a new nodule in her scalp developed and turned out to be a metastatic nodule. A broncho-mediastinal fistula was suspicious on follow-up chest computed tomography and a broncoscopy revealed an extensively damaged medial right main bronchial wall. On the day following bronchoscopy, the patient died of sudden massive hemoptysis.
Bronchi ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung ; Female ; Fistula ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung Neoplasms ; Maintenance Chemotherapy ; Middle Aged ; Palliative Care ; Photochemotherapy ; Scalp ; Thorax ; Triazenes

Historically, German chamomile (GC) oil has been used for treatment of skin disorders. BALB/c mice were sensitized twice a week with 100 microL of 1% 2,4-dinitrochlorobenzene (DNCB) and challenged twice the following week with 100 microliter of 0.2% DNCB for atopic dermatitis induction. Thereafter, 3% GC oil was applied daily (70 microliter, 6 times week) on the dorsal skin for 4 weeks. Saline or jojoba oil was used for the control mice. Blood was collected after second DNCB challenge, and at 2 and 4 weeks after initiating oil application. Serum IgE levels were significantly lowered in the GC oil application group at the end of the 4-week application period. The GC oil application for 4 weeks resulted in reduction in serum IgG1 level compared with that after 2-week application. The GC oil application group showed a significantly lower serum histamine level than the control group 2 weeks after oil application. Scratching frequency of the GC oil application group was significantly lower than either control groups. This study is to demonstrate GC oil's immunoregulatory potential for alleviating atopic dermatitis through influencing of Th2 cell activation.
Animals ; Behavior, Animal/drug effects ; Chamomile/*immunology ; Dermatitis, Atopic/drug therapy/*immunology ; Disease Models, Animal ; Histamine/blood ; Immunoglobulin E/blood ; Immunoglobulin G/blood ; Interleukin-4/analysis ; Male ; Matricaria/*immunology ; Mice ; Mice, Inbred BALB C ; Phytotherapy/*methods ; Specific Pathogen-Free Organisms ; Th2 Cells/*immunology

PURPOSE: This study was performed to examine the effects of image filter on observer performance by counting the number of holes at each wedge step on a radiographic image. MATERIALS AND METHODS: An aluminum step wedge with 11 steps ranged in thickness from 1.5 mm to 16.5 mm in 1.5 mm increments was fabricated for this study. Each step had 10 notched holes with 1.0 mm diameter on the bottom of the step wedge which were ranged in depths from 0.1 mm to 1.0 mm in 0.1 mm increments. Digital radiographic raw images of the aluminum step wedge were acquired by using CCD intraoral sensor. The images were processed using several types of noise reduction filters and kernel sizes. Three observers counted the number of holes which could be discriminated on each step. The data were analyzed by ANOVA. RESULTS: The number of holes at each step was decreased as the thickness of step was increased. The number of holes at each step on the raw images was significantly higher than that on the processed images. The number of holes was different according to the types and kernel sizes of the image filters. CONCLUSION: The types and kernel sizes of image filters on observer performance were important, therefore, they should be standardized for commercial digital imaging systems.
Aluminum ; Noise ; Radiographic Image Enhancement ; Radiography, Dental ; Task Performance and Analysis

Finite element analyses were performed to study effects on stress distribution generated in jaw bone for various shapes of dental implants: plateau type, plateau with small radius of curvature, triangular thread screw type in accordance with ISO regulations and square thread screw filleted with small radius partially. It was found that square thread screw filleted with small radius was more effective on stress distribution than other dental implants used in analyses. Additional analyses were performed on the implant with square thread screw filleted with small radius for verying design parameters, such as the width of thread end, the height of the thread of the implant and load direction, to determine the optimum dimensions of the implant. The highest stress concentration occurred at the region in jaw bone adjacent to the first thread of the implant. The maximum effective stress induced by a 15 degree oblique load of 100 N was twice as high as the maximum effective stress caused by an equal amount of vertical load. Stress distribution was more effective in the case when the width of thread end and the height of thread were p/2 and 0.46p, respectively, where p is the pitch of thread. At last, using tensile force calculated from the possible insert torque without breading bone thread, finite element analysis was performed on the implant to calculate pre-stress when the primary fixation of the implant was operated in jaw bone. The maximum effective stress was 136.8 MPa which proven to be safe.
Bread ; Dental Implants ; Finite Element Analysis ; Jaw ; Radius ; Social Control, Formal ; Torque