It can be speculated that the thinned and flattened central cornea after excimer laser photorefractive keratectomy (PRK) might give a falsely low Goldmann applanation tonometer(GAT) reading. We studied 353 eyes of 264 patients who underwent PRK to determine the effect of excimer laser PRK on the accuracy of Goldmann applanation tonometry. PRK was done with a VISX 20/20 excimer laser and topical fluorometholone was used after PRK. The intraocular pressure(IOP) was measured with the GAT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean ablation depth of the cornea was 71.4 +/- 22.0 micrometer, and the eyes were divided into three groups according to their ablation depths. The mean postoperative IOP measured with the GAT decreased as compared with the mean preoperative IOP(P<0.01). The mean postoperative IOP at 9 or 12 months was lower than that at 1, 3, or 6 months(p<0.05). The mean IOP(11.9 +/- 2.5 mmHg) at 12 months was 2.8 mmHg lower than the mean preoperative IOP(14.7 +/- 2.7 mmHg). There was no statistically significant difference in the amount of postoperative IOP decrease among the three groups.
Cornea ; Fluorometholone ; Humans ; Lasers, Excimer* ; Manometry* ; Photorefractive Keratectomy*

The authors' clinical experience has suggested that the noncontact tonometer (NCT) has a tendency to record a lower intraocular pressure(IOP) than the Goldmann applanation tonometer(GAT) after excimer laser photo refractive keratectomy(PRK). This study was done to verify this tendency. We performed PRK on 177 eyes of 122 patients using a VISX 20/20 excimer laser, and topical fluorometholone was used after PRK. The eyes were divided into three groups according to their ablation depths, and the IOP was measured with the GAT and the Topcon NCT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean postoperative IOP measured with the GAT or the NCT decreased as compared with the mean preoperative IOP(GAT: 1.67 ~ 2.90 mmHg, NCT:5.27 ~ 6.54 mmHg). The mean NCT reading was 1.12 mmHg higher than the mean GAT reading preoperatively, but was 2.48 ~ 2.88 mmHg lower than the mean GAT reading postoperatively. Difference between GAT and NCT measurements postoperatively was more prominent in the group of deeper ablation. These results suggest that we should be cautious of evaluating the IOP measured with the GAT or the NCT after PRK.
Fluorometholone ; Humans ; Intraocular Pressure ; Lasers, Excimer* ; Photorefractive Keratectomy*

We report herein a case of lymphomatoid papulosis showing atypical clinical manifestations. A 54- year-old man had had recurrent erythematous necrotic papules and nodues, numbering more than 200 lesions at the most aggravated time, on the trunk, extremities, buttok, and face for the last twenty years. Recently, he complained of tender swelling on the neck, axillae, and inguinal lymph nodes accompanied by mild fever and gerneral weakness. We had performed thorough examinations including biopsy from the skin lesions, lymph node, and bone marrow to detect some evidences of transforming to malignant lymphoma, but found no evidence of malignant lymphoma except aneuploidy on DNA histogram. The patients showed proinpt response to methotrexate 10-30mg par week wit,hout showing distinct side reactions to the accurvulated dose of 780mg for the last 16 months.
Aneuploidy ; Axilla ; Biopsy ; Bone Marrow ; DNA ; Extremities ; Fever ; Humans ; Lymph Nodes ; Lymphoma ; Lymphomatoid Papulosis* ; Methotrexate ; Neck ; Skin

It has been widely accepted that the detachable balloon catheter technique is the treatement of choice in thecarotid-cavernous fistula and in the unclippable giant aneurysm at the cavernous or petrous portion of theinternal carotid artery. The authors successfully treated one case of the carotid-carvernous fistula and one caseof giant aneurys, located in petrous portion of the internal carotid artery using Debrun's latex datachableballoon catheter technique. In thecase with carotid-cavernous fistula, the only fistula was occluded with adetachable balloon, presserving the intrenal carotid artery. In the aneurysm case, both internal carotid arteryand aneurysm itself were completely occluded with 3 latex detachable balloons. Both patients have nocomplications. The authors will describe and discuss the Debrun's latex detachable balloon catheter technique.
Aneurysm ; Carotid Arteries ; Carotid Artery, Internal ; Catheters ; Fistula ; Humans ; Latex

No abstract available.

BACKGROUND: Nerve ligation injury in rats produces a pain syndrome that includes mechanical allodynia. Intrathecal administration of cholinesterase inhibitors or adenosine receptor agonists have anti-allodynic effects in this model. Therefore, we tested the interaction between intrathecal neostigmine and N(6)-cyclohexyladenosine (CHA) in a rat behavioral model of neuropathic pain. METHODS: Male Sprague-Dawley rats were prepared with tight ligation of the spinal nerves for producing allodynia and with a lumbar intrathecal catheter for drug administration. Allodynia thresholds for hindpaw withdrawal against mechanical stimuli were assessed and converted to percent maximal possible effect. Neostigmine (0.3-10 microgram) and CHA (0.03-3 microgram) were administered to obtain the dose-response curves and the 50% effective dose (ED(50)). Equal fractions (1/2, 1/4 and 1/8 ED(50)s) of the two drugs were administered to establish the ED(50) of neostigmine-CHA combination. Side effects were also assessed. The drug interaction was evaluated by isobolographic and fractional analyses. RESULTS: Neostigmine, CHA, and the neostigmine-CHA combination dose-dependently produced anti-allodynia effects. Side effects such as sedation and motor weakness were similar in the three groups. In the isobolographic analysis, the experimental ED(50) for the combination of neostigmine-CHA lay far below and to the left of the theoretical additive line. Fractional analysis indicated that the total combination fraction of the two drugs was 0.39. CONCLUSIONS: Intrathecal co-administration of neostigmine and CHA showed a synergistic anti-allodynia effect.
Adenosine ; Animals ; Catheters ; Cholinesterase Inhibitors ; Drug Interactions ; Humans ; Hyperalgesia ; Injections, Spinal ; Ligation ; Male ; Neostigmine ; Neuralgia ; Purinergic P1 Receptor Agonists ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves

Airway management during carinal resection should provide adequate ventilation and oxygenation as well as a good surgical field, but without complications such as barotraumas or aspiration. One method of airway management is high frequency jet ventilation (HFJV) of one lung or both lungs. We describe a patient undergoing carinal resection, who was managed with HFJV of one lung, using a de-ballooned bronchial blocker of a Univent tube without cardiopulmonary compromise. HFJV of one lung using a bronchial blocker of a Univent tube is a simple and safe method which does not need additional catheters to perform HFJV and enables the position of the stiffer bronchial blocker more stable in airway when employed during carinal resection.
High-Frequency Jet Ventilation/*instrumentation/*methods ; Humans ; Lung/*surgery ; Lung Neoplasms/*surgery ; Male ; Middle Aged ; Pulmonary Surgical Procedures/*instrumentation/*methods

BACKGROUND: Amlodipine ; 2-<(2-aminoepoxi)methyl>-4-(2-chlorophenyl)-3-ethoxycarbonyl-5-methoxycarbonyl-6-methyl-1,2, dihydropyridine) is a novel calcium channel antagonist of long half-life and steady state blood levels. However, its blood pressure lowering effect throughout the day has not been well documented especially in Korean patients with essectial hypertension. Therefore, antihypertensive effect of amlodipine in Korean patients with mild to moderate hypertension was evaluated with using 24 hour ambulatory blood pressure measurement(ABPM) as well as office blood pressure measurement. METHODS: Total 25 subjects(M;F=13:12, mean age;53.4+/-7.3 yrs) with mild-to-moderate essectial hypertension had completed the study. After 2 weeks of placebo, amlodipine was mediciated for 12 weeks. Initially, amlodipine was given as 5mg once a day and the daily dose was increased to 10mg/day if diastolic blood pressure in over 90mmHg at the 8th week of medication. The blood pressure level was measured every 4weeks during medication in sitting position('office blood pressure level') and 24 hour ambulatory blood pressure monitoring(ABPM) was done at the placebo run-in phase and at the 8th week of medication. RESULTS: In the view of' office blood pressure lever', the blood pressure lowering effect of amlodipine was already impressive at 4 weeks after medication. The systolic(placebo; 165.3+/-16.9mmHg, arter 4 wk of medication; 136.1+/-16.0mmHg, 8 wk; 136.0+/-12.9mmHg, 12wk; 133.2+/-10.7mmHg) and diastolic blood pressure(placebo; 104.1+/-11.0mmHg,after 4 wk of medication; 87.4+/-6.8mmHg, 8 wk; 86.0+/-6.5mmHg, 12 wk; 84.7+/-5.4mmHg)fell significantly, and most patients had both satisfactory systolic(<160mmHg) and diastolic(<90mmHg) blood pressure levels. And such antihypertensive effects were main tained throughout study period. In contrast, the heart rate did not change significantly. The blood pressure lowering effects assessed by 24 hour AVPM were slightly milder, but absolute systolic and diastolic blood pressures by ABPM after 8 weeks of meddication were as low as those of office measurement. The blood pressure lowering effect was maintained throughout the day including morning periods without either rebound blood pressure elevation or reflex tachycardia. The percent reduction of systolc and diastolic vlood pressure with amlodipine were 17% in office blood pressure measurement and 10% in ABPM. During medication, neither significant side effects nor discomforts that lead to discontinuation of the drug has not been observed. Mild edmatous feeling in 3 subjects, flushing in one and palpitation in one were reported. CONCLUSION: Amlodipine is an effective antihypertensive drug that can control the elevated blood pressure in most patients with mild-to-moderate essential hypertension by monotherapy of once a day regimen without serious side effects.
Amlodipine* ; Blood Pressure* ; Calcium Channels ; Flushing ; Half-Life ; Heart Rate ; Humans ; Hypertension* ; Reflex ; Tachycardia

A blind, comparative clinical study was performed prospectively to examine the correlation between image quality of CT scan in terms of contrast enhancement effect and amount of intravenous contrast media. A total of 357 patients were randomized into two groups. Ionic high-osmolality contrast media (68% meglumine ioglicate) was administered intravenously as 100ml bolus in one group and as 50 ml bolus in the other group. Statistically significant differences of image quality were found in CT scans of the brain, head and neck, chest and abdomen(p<0.05). However in the pelvis, difference was not statistically significant. (p>0.05). We suggest that amount of contrast media may be reduced in pelvis CT without significant degradation of image quality.
Brain ; Clinical Study ; Contrast Media* ; Head ; Humans ; Meglumine ; Neck ; Pelvis ; Prospective Studies ; Thorax ; Tomography, X-Ray Computed*

Fibroepithelial polyps are benign soft tissue tumors that occur in a wide variety of sites, including the lower female genital tract. They exhibit a wide range of morphologic appearances and can be misinterpreted as malignant. A 16-year-old woman presented with a 28x27 cm polypoid lesion localized on the right labium. The labial lesion was resected and recurred 6 years following the initial treatment. The histologic findings of the initial and recurrent lesions were consistent with fibroepithelial polyps. We present a case of a fibroepithelial polyp that is larger than any previously described lesion and recurred lesion with a brief review of the literature.
Adolescent ; Female ; Humans ; Polyps ; Vulva