No abstract available.
Carotid Artery, Common* ; Rupture*

No abstract available.
Sinusitis*

This study evaluated the risk factor of glaucoma progression despite of adequate intraocular pressure[IOP]and that of glaucomatous optic nerve head progression before visual field progression with minimum treatment regimen. Inclusion criteria included subjects with elevated intraocular pressure and glaucomatous optic nerve head in fundus examination. Patients were main-tained their IOP by medication or filtering surgery. Baseline assessment included routine ocular examination, Heidelberg Retina Tomograph[HRT]and visual field. All patients were reexamined 6 months after the first examina-tion. We review the results of 61 patients[118 eyes]. In multiple logistic regression analysis, the risk factors of glaucoma progression were age[p=0.027] and the intraocular pressure at the first HRT examination[p=0.0216]. Glaucomatous visual field progression correlated significantly with HRT progres-sion[p=0.0216]. If the early glaucoma progression is detected with HRT, progression of glaucoma can be prevented. In the groups with the risk factors, the target pressure should be lower to prevent further loss or blindness with agressive treatment. In groups without risk factor, the quality of patient's life can be improved with minimum treatment. We may be able to prevent the progression of glaucomatous field defect, if we can recognize the early change of their optic nerve head morphology. Their findings may help us to differentiate non-risk group from risk group. We hope that we would improve our patient's life quality by minimizing glaucoma treatment especially in the non-risk group.
Blindness ; Filtering Surgery ; Glaucoma ; Hope ; Humans ; Intraocular Pressure ; Logistic Models ; Optic Disk* ; Optic Nerve* ; Quality of Life ; Retina* ; Risk Factors* ; Visual Fields

p27 is a cyclin dependent kinase inhibitor and plays an important role in negative regulation of the cell cycle. It has been revealed that down-regulation of p27 is frequently found in various cancers and is well associated with their malignancies including poor prognosis. In the present work, we constructed including inhibition of cell proliferation, arrest of cell cycle, and induction of apoptosis in head and neck squamous cell carcinoma (HNSCC)cells. On transduction of the HNSCC cell lines with ad-p27, overexpression of p27 was confirmed in all cell lines tested. In addition, overexpression of p27 resulted in significant inhibition of cancer cell proliferation with increased apoptosis and cell cycle arrest in HNSCC cell lines. From these results, it was suggested that overexpression of p27 could show anti-tumor effects in HNSCC cell lines and it is possible that an increase of p27 protein by introducing the p27 gene into human cancer cells may be helpful for the treatment or prevention of human cancers, especially HNSCC.
Apoptosis ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line* ; Cell Proliferation ; Cyclins ; Down-Regulation ; Head* ; Humans ; Neck* ; Phosphotransferases ; Prognosis

OBJECTIVE: The frontal sinus is frequently a troublesome anatomical obstacle to gain access to the medial anterior cranial base. Surgical approaches to and through the frontal sinus using osteoplastic frontal sinusotomy provide significant advantages to the treatment of lesions of the medial anterior cranial base in addition to the frontal sinus itself. However, appropriate management is necessary to avoid postoperative complications such as cerebrospinal fluid leakage, infection, mucocele formation, and deformity of the forehead. METHODS: The advantages and shortcomings of the approach along with the surgical technique are reported based on our clinical experience with pertinent literature review. The approach using the osteoplastic frontal sinusotomy was applied to two cases of osteoma in the frontal sinus, seven cases of craniofacial tumors, a case of chordoma in the sphenoid and clivus, and two cases of intradural lesions in the anterior cranial fossa. The frontal sinus was managed in such a way as to prevent the postoperative complications. RESULTS: All patients underwent gross total resection of the tumors. With a mean follow-up of 26 months, there were no postoperative complications related to frontal sinus violation. CONCLUSION: The neurosurgical approaches via the frontal sinus using osteoplastic frontal sinusotomy are versatile for various lesions of the anterior cranial base in patients with large frontal sinuses. In situations that the frontal sinus have to be violated to approach medial anterior cranial base, the osteoplastic frontal sinusotomy provides such advantages as optimal frontal sinus control to prevent postoperative complications; increases viewing angle with superior trajectory from nasofrontal suture; lower incidence of pnemocephalus due to minimal dural exposure; and excellent cosmesis without frontal burr holes.
Cerebrospinal Fluid ; Chordoma ; Congenital Abnormalities ; Cranial Fossa, Anterior ; Cranial Fossa, Posterior ; Follow-Up Studies ; Forehead ; Frontal Sinus* ; Humans ; Incidence ; Mucocele ; Osteoma ; Postoperative Complications ; Skull Base ; Sutures

No abstract available.
Acute Kidney Injury* ; Back Pain*

Purpose: We report two cases of tacrolimus-related transplant-associated thrombotic microangiopathy (TA-TMA) retinopathy in leukemia patients who had undergone allogenic peripheral blood stem cell transplantation (PBSCT).Case summary: (Case 1) A 58-year-old woman with a history of PBSCT due to acute myelocytic leukemia and taking tacrolimus was referred to the ophthalmology clinic with visual disturbance. Her visual acuity (VA) was 0.4 in the right eye and 0.5 in the left eye. Multiple cotton wool spots and retinal hemorrhages were found in both eyes on fundus examination. Multiple capillary non-perfusions were seen on fluorescein angiography (FA). Tacrolimus-related TA-TMA retinopathy was suspected. Tacrolimus was discontinued and plasmapheresis was performed. After 3 months, neovascular glaucoma developed and her VA became “counting fingers” at 20 cm in both eyes. (Case 2) A 20-year-old man with a history of PBSCT due to acute lymphocytic leukemia and taking tacrolimus was referred to our clinic because of decreased VA in both eyes. His VA was 0.05 in the right eye and 0.025 in the left eye. Fundus and FA findings were the same as in Case 1, and the patient was suspected to have tacrolimus-related TA-TMA retinopathy. Tacrolimus was discontinued and plasmapheresis was performed. His VA was 0.2 in the right eye and 0.4 in the left eye at 1 month after treatment. Conclusions It is necessary to consider TA-TMA retinopathy in leukemia patients taking calcineurin inhibitors, such as tacrolimus, who have decreased VA. Early diagnosis and treatment are important.

Many studies have cited occurrences of severe and long-lasting emotional disturbances of almost every kind after surgical procedures, particularly due to the sedatives or narcotics which were administered to control the post-operative pain. In order to control this post-operative pain, pediatric caudal analgesia was performed in 15 infants and children from the age 2 months to 6 years, who were to undergo lower abdomen, perineum and lower extremity surgery. They were induced with inhalation anesthoeia, using nitrous oxide, oxygen and halothane by mask before and during the block. Following the block, infants and children were turned to supine position and the initial concentration of halothane was reduced. All cases were given 10mg/kg of 1% solution of lidocaine. On examination of the level of the analgesia, 13 out of 15 cases had spread higher level than T10, with effective block for surgical procedures. The identification of the sacral cornu is easy and technical failureis lees in comparison than with the lumbar epidural block for infants and children. Thus we can perform this block successfully for infants and children without any complications or accidents. It is especially helpful in the management of postoperative cases due to the effect in control of the postoperative pain. Thus it gives satisfaction to their parents, nurses and doctors. Despite no follow-up study on postoperative emotional reactions, it was considered that there were minimal occurrences of emotional and behavioral sequelae following the hospital and surgical experiences.
Abdomen ; Affective Symptoms ; Analgesia ; Anesthesia, Caudal* ; Child ; Follow-Up Studies ; Halothane ; Humans ; Hypnotics and Sedatives ; Infant ; Inhalation ; Lidocaine ; Lower Extremity ; Masks ; Narcotics ; Nitrous Oxide ; Oxygen ; Pain, Postoperative ; Parents ; Perineum ; Supine Position

BACKGROUND: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues to increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of the adolescent smoking cessation program performed by the Seoul School Health Center. METHODS: Four hundred and twenty adolescent smokers referred from their schools from March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed. RESULTS: Males were found to have a higher rate of daily smoking as compared with females. Middle school students had a earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGA-R. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smakers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their schools, experienoe of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed. CONCLUSIONS: To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.
Adolescent* ; Child ; Female ; Homeless Youth ; Humans ; Logistic Models ; Male ; Motivation ; Program Evaluation ; Public Health ; Punishment ; School Health Services ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking*

BACKGROUND: An accurate ABO blood type is essential for transfusion therapy. Genetic structures of ABO blood group and subgroup have been investigated and so far about 100 ABO alleles have been reported worldwide. This study was performed to investigate the molecular characteristics of B subgroups in the Korean population. METHODS: A total of 19 samples of B subgroups were collected from patients (n=11) and from blood donors (n=8) of Korean Red Cross blood centers; these samples had been typed serologically for the ABO blood group. Allele-specific polymerase chain reaction (PCR), direct sequencing of exon 6 and 7, and allele separation were performed for ABO gene analysis. RESULTS: The ABO PCR-RFLP genotyping results of 18 samples among the provisional 19 B subgroups were identical regardless of their phenotypes. Two new B alleles showing 255C>T base change and 547G>A base change were observed in B3 and A1B3 subgroups. CONCLUSIONS: Serologically unidentified B subgroups were unequivocally identified through molecular analyses of the ABO gene. And new ABO alleles observed only in the Korean B subgroups were recognized.
Alleles ; Asian Continental Ancestry Group ; Blood Donors ; Exons ; Genetic Structures ; Humans ; Phenotype ; Polymerase Chain Reaction ; Red Cross