In case of severe blepharoptosis, frontalis muscle suspension with fascia or frontalis transfer has been popular for decades, but these static procedures have some disadvantages such as lagophthalmos, lid lag and remnant ptosis. Twenty-six patients with severe blepharoptosis who underwent frontalis suspension, frontalis transfer, or levator resection at Yonsei University Severance Hospital from 1980 to 1988 were studied. The follow-up period of patients ranged from 10 to 18 years with a mean of 12 years. Surveys and clinical results were obtained, In our review of postoperative complications, lagophthalmos persisted in sleep and even in forced eye closure in most patients 2 to 6 months after operation. But no recurrence was noted. In conclusion, undercorrection of ptosis is more desirable than overcorrection. As well levator resection can be considered in selected cases to prevent complications.
Blepharoptosis* ; Fascia ; Follow-Up Studies* ; Humans ; Postoperative Complications ; Recurrence

No abstract available.
Cytokines* ; Macrophages*

No abstract available.
Cardiac Tamponade* ; Leukemia, Myeloid, Acute*

PURPOSE: It is important for the physician and a rape counselor to understand epidemiology studies of the incidence, prevalence, spread, prevention, and control of sexual assault in a local community or a specific group of individuals. We did this study in order to find an effective treatment for the sexual assault victims and to establish a data base on them. METHODS: We prospectively evaluated sexually assaulted patients who visited the Medical Supportive Center for Women at the National Police Hospital from Oct. 11, 2001, to Oct. 10, 2002. The data were obtained from the records of the ER (emergency room) and OB & GY (obstetric & gynecologic) clinic; a total of 169 patients were evaluated. RESULTS: The mean age was 20.1 years old. The age distribution of sexual assault victims was divided into four: 14 cases under 7 years of age (8.3%), 26 cases between ages 7 and 13 years (15%), 43 cases between ages 14 and 19 years (26.3%), and 86 cases over 20 years of age (52.6%). Of the patients, 157 (92.9%) were unmarried and 117 (69.2%) were examined within 1 hour after visiting the hospital. The physical injuries were 15 vaginal injuries (26.9%), 34 ruptures of the hymen (16.9%), 1 sexually transmitted disease (0.6%), 57 abnormal sensations of the genital organ (28.3%), and 55 minor injuries including abrasions, contusions, and lacerations (27.3%). The psychological injuries were 105 phobias (21.4%), 92 anxieties (18.8%), 68 angers (13.9), 51 guilts (10.4%), and the like. Eighty-eight patients (52.1%) were acquainted with the assailant. CONCLUSION: Optimal management of sexual assault victims should involve continuous epidemiologic analysis and the estalishment of an assault-victim data base.
Age Distribution ; Anger ; Anxiety ; Contusions ; Counseling ; Epidemiology ; Female ; Genitalia ; Guilt ; Humans ; Hymen ; Incidence ; Lacerations ; Phobic Disorders ; Police ; Prevalence ; Prospective Studies ; Rape ; Rupture ; Sensation ; Sexually Transmitted Diseases ; Single Person

BACKGROUND: renal artery stenosis (RAS) is a major cause of renovascular hypertension and renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS. METHOD: From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis (11 male, 6 female). the mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu's disease in 2, and autoimmune disease (Bechet's) in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination. RESULT: the degree of renal artery stenosis was 83% (70-95%). the lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-2 stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases. CONCLUSION: Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.
Angioplasty ; Atherosclerosis ; Atrophy ; Autoimmune Diseases ; Blood Pressure ; Brachial Artery ; Constriction, Pathologic ; Emergencies ; Femoral Artery ; Fibromuscular Dysplasia ; Follow-Up Studies ; Hematoma ; Humans ; Hypertension, Renovascular ; Kidney ; Male ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Renal Artery Obstruction* ; Renal Artery* ; Stents*

No abstract available.
Lupus Erythematosus, Systemic*

Hypothalamic hamartomas are often associated with early onset gelastic seizures, precocious puberty, behavioral problem and suboptimal response to antiepiletptic drugs. Until now, four surgical options have been reported to reduce seizure by >50%. Surgical excision have good seizure outcome but postoperative complications were not infrequent, whether by pterional or transcallosal interforniceal approach. Radiosurgery is noninvasive alternative to resective surgery but the effect usually does not appear until several months later. Radiofrequency ablation is less invasive than surgical resection and its effect is immediate, but lacks long term follow-up data. It also requires three dimensional analysis of the lesion to enhance effi cacy and safety. As hypothalamic hamartoma is intrinsically epileptogenic and epileptogenic discharges spread from the lesion, blocking the seizure propagation through endoscopic disconnection is regarded as an effective and safer option. Surgical choice for a particular patient should take into account the hamartoma’s size, location, surgeon’s preferences, possible complication as well as the effect and risk of the various surgical methods. In the present review, open surgery, endoscopic disconnection, radiosurgery and radiofrequency ablation are discussed.

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

BACKGROUND: The aim of the study was to determine prevalence of potential heterogeneous vancomycin-resistant Staphylococcus aureus (h-VRSA) among methicillin-resistant S. aureus (MRSA) isolated in Korea by using Mu-3 agar and to determine the effect of in vitro vancomycin exposure on the resistance. METHODS: MRSAs isolated in 1980-1999 were screened for the presence of VISA or h-VRSA using Mu-3 agar. MIC of vancomycin was tested by NCCLS agar dilution and broth microdilution tests. Suspected h-VRSA were selected by vancomycin-containing media and change of resistance was determined by population analysis. A strain with Mu50 type growth was serially exposed to 8 pg/ml of vancomycin containing media and change of the vancomycin resistance was determined. RESULTS: Among the 455 MRSA isolates, 18 (3.9 %) grew on selective brain heart infusion agar (BHIA), and 354 (77,8%) on Mu-3 agar, 66 (14.5%) with Mu3 type growth and 78 (17.1%) with Mu50 type growth. MIC of vancomycin was 11 pg/ml for some of the isolates when inocula were approximately 10' CFU, but VISA was not present when tested by NCCLS broth microdilution test. Exposure of the isolates to van-cornycin raised the MIC. Serial exposure once to 8 pg/ml of vancomycin resulted in significant decrease of cells susceptible to 8-12 pg/ml of vancomycin. CONCLUSION: VISA was not present among the test isolates, but 34.2% were suspected to be potential h-VRSAs, suggesting possible emergence of VISA if vancomycin was administered prolonged period. It is considered that suitable screening media are vancomycin containing BHIA for VISA and Mu-3 agar for h-VRSA. The isolates showing Mu50 type growth on Mu-3 agar are not always VISA, but rather h-VRSA.
Agar* ; Brain ; Heart ; Korea ; Mass Screening ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin Resistance ; Vancomycin*

No abstract available.
Angiofibroma*