Marfan's syndrome is a widespread disturbance of mesodermal tissue throughout the body. The main disturbances are characteristic skeletal anomaly, cardiopathy and eye disturbance such as lens dislocation, glaucoma, etc. Marfan originally described it under the name of dolichostenomelie in 1896. Since then, many cases have been reported in the literature. Authors experienced 3 cases of Marfan's syndrome and 2 cases were operated. The result of surgical treatment. other clinical findings, and brief review of literature are reported as following.
Glaucoma ; Lens Subluxation ; Marfan Syndrome* ; Mesoderm

No abstract available.
Maxillary Sinus Neoplasms* ; Maxillary Sinus*

Vitreous surgery has become a widly practiced procedure for use in the variety of pathological conditions in the anterior and posterior semgment of the eye. The goal of the vitreous 'surgery is to clear the optic pathway and restore the anatomy and function of the eye. Vitreous surgery was performed in 28 eyes using the O'malley ocutome from April, 1980 to October, 1980. Among the 28 eyes, 14 eyes received anterior segment surgery and the other 14 eyes received posterior segment surgery. The follow up period after surgery ranged from 3 weeks to 7 months and the average period was 4 months. The conditions requiring surgery were as follows: 9 eyes had Reconstruction of anterior segment after trauma; 4, removal of pupillary membrane due to chronic uveitis and after cataract; and 1, anterior vitrectomy with removal of subluxated lens. As for the causes of posterior segment surgery, 5 eyes had trauma of eyeballs; 3, hypertensive retinopathies; 2, vitreous opacity with retinal detachment; 1, diabetic retinopathy; 1, central retinal vein occlusion; 1, nonmagnetic intraocular foreignbody; and 1, lost lens nucleus into the vitreous. The improvement of visual acuity after surgery was seen in 14 eyes (50%), 9 eyes in anterior segment surgery and 5 eyes in posterior segment surgery. The complications during operation were vitreous hemorrhage (1 eye; 3.5%), retinal detachment (2 eye; 7%), and traumatic cataract (1 eye; 3.5%). Postoperative complications were phthisis bulbi (1 eye; 3.5%), and cataract (1 ; 3.5%). We found that vitreous surgery is not only useful to removal of the various pathologic conditions of vitreous through the pars plana approach but in anterior segment as an emergency procedure at the time of trauma and vitreous loss during anterior segment surgery.
Cataract ; Diabetic Retinopathy ; Emergencies ; Follow-Up Studies ; Hypertensive Retinopathy ; Membranes ; Postoperative Complications ; Retinal Detachment ; Retinal Vein ; Uveitis ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND: The inhibitory effects of nitric oxide(NO) on platelet adhesion and vascular smooth muscle cell(VSMC) proliferation may have a possible role inhibiting development of neointima following balloon catheter induced injury. We tested the hypothesis that L-arginine, the precursor of NO, would attenuate neointima formation following balloon catheter induced injury via regulation of antagonistic balance between proliferation and apoptosis of VSMC. METHODS: Adult, male Sprague-Dawley rats(300 to 400g) were anesthetized with ketamine (100mg/kg intraperitoneally). The left common and external carotid artery were exposed. For endothelial denudation, 2mm angioplasty catheter was introduced through the left external carotid artery into the left common carotid artery. The catheter was inflated at I atm. and withdrawn three times. Animals were randomized to receive 2.25% L-arginine in their drinking water(n=14) or placebo(n=16) from 2 days prior to and 9 days following denudation. VSMC proliferation was quantified by immunohistochemical staining with an antibody to the proliferating cell nuclear antigen(PCNA). The cells undergoing apoptosis were identified by terminal nucleotidyl transferase-mediated nick end labeling(TUNEL) method and morphologic changes by computerized planimetry and transmission electron microscopy. RESULTS: 1) The neointimal area in injured arteries were significantly reduced in L-arginine supplemented animals compared with placebo group(p<0.05). 2) L-arginine administration significantly reduced the number of PCNA positive cells in neointima when compared with placebo at 9 days(p<0.05). 3) Positive TUNEL cells were not influenced by L-arginine supplementation. 4) On transmission electron microscopy, there were no cells showing characteristics of apoptosis in neointima. CONCLUSION: These results suggested that the inhibitory effect of L-arginine on neointima formation is due to reduced VSMC proliferation, but is not due to increased VSMC apoptosis at the early time period after initmal injur .
Adult ; Angioplasty ; Animals ; Apoptosis ; Arginine* ; Arteries ; Blood Platelets ; Carotid Artery, Common ; Carotid Artery, External ; Catheters ; Drinking ; Humans ; In Situ Nick-End Labeling ; Ketamine ; Male ; Microscopy, Electron, Transmission ; Muscle, Smooth, Vascular ; Neointima* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Vascular System Injuries*

Although we managed a patient with traumatic endophthalmitis with potent antibiotics for 7 days topically and systemically, her clinical symtoms and signs did not improved and her visual activity decreased from hand motion to light perception. So, we performed pars plana vitrectomy and lensectomy using the Ocutome(R) and Frognatome(TM) and achieved a successful result with final visual acuity of 50 cm finger count or better without evidence of phthisis bulbi in this case.
Anti-Bacterial Agents ; Endophthalmitis* ; Fingers ; Hand ; Humans ; Visual Acuity ; Vitrectomy*

In a study of primary brain tumors 104 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to April, 1985. The resultswere as follows: 1. The male to female ratio of primary brain tumor was 54:46. 2.The 2nd decade group (26%) wasthe most prevalent age group, followed by the 5th decade(16.3%), 1st decade(14.4%), 3rd decade(12.5%), 4thdecade(11.5%), 6th decade(10.6%), 7th decade(8.7%) in that order. 3. The incidence of primary brain tumors was found to be: glioma 64 cases(61.6%) (among the GM, the most frequent 17 cases(16.3%), followed by meningioma 12cases (11.5%), pituitary adenoma 10 cases (9.6%), craniopharyngioma 6 cases(5.8%), pinealoma and germinoma 3cases(2.9%) respectively, and dermoid cyst 2 cases(1.9%) in that order. 4. The locations of the primary braintumors were as follows: cb. hemisphere(49%) of these 24.5% in parietal region, 11.9% in temporal region, 9.7% infrontal region, 3.0% in occipital region: Juxtasella area(16.3%), cerebellar hemisphere(8.7%), Parapineal andintraventricle(7.7%) respectively, cerebello-pontine angle area(5.8%), vermis and 4th ventricular region(4.8%). 5.There were no remarkable differences in the findings of pre-and post-contast CT scanning of primary brain tumorscompared with others.
Brain ; Brain Neoplasms ; Craniopharyngioma ; Dermoid Cyst ; Female ; Germinoma ; Glioma ; Humans ; Incidence ; Male ; Meningioma ; Occipital Lobe ; Parietal Lobe ; Pinealoma ; Pituitary Neoplasms ; Protestantism ; Temporal Lobe ; Tomography, X-Ray Computed

In a study of intacranial metastases, 46 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. Theresults were as follows: 1. The male to female ratio of itracranial metastases were 67:33. The 5th decade group(34.8%) was the most prevalent age group, followed by the 6th decade(21.7%) and 7th decade(21.7%). 2. The numberof lesions was found to be: single-25 cases(54.3%); multiple-21 cases(45.7%). 3. The source of intracranialmetastases found to be: lung 15 cases(32.6%); unknown 12 cases(26.0%); chorioca 3 cases(6.5%); liver 3cases(6.5%); liver 3 cases(6.5%); stomach 2 cases(4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca.rhabdomyosarcoma, nasal ca. lymphoma, testicular ca, cervix, each 1 case(2.2%). 4. The locations of theintracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebra hemisphere 15.9% inin frontal region Cerebral hemisphere 13.4% in occipital region Cerebra hemisphere 10.5% in temporal regionCerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5.Peritumor edema was found to be: Grade II-17 cases(37.0%): Grade III-14 cases(30.4%); Grade I-8 cases(17.4%);Grade 0–7 cases(15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were asfollows: Headache 30 cases(65.2%); Vomiting 11 casees(23.9%); deteriorated mental state 10 cases(21.6%);Hemiplegia 7 cases(15.2%); visual disturbance 6 cases(13.0%); hemiparesis 4 cases(8.7%); seizure 4 cases(8.7%);other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases(39.1%);hypodense lesions in 15 cases(32.6%); mixed density in 8 cases(17.4%); isodenisty was present in 5 cases(10.9%).On post-contrast scan, ring enhancement was seen in 19 cases(41.3%); nodular enhancement in 17 cases(37%); mixedring-nodular enhancement in 8 cases(17.4%); only hypodense 2 cases(4.3%).
Breast ; Cerebellopontine Angle ; Cerebrum ; Cervix Uteri ; Edema ; Female ; Headache ; Humans ; Kidney ; Liver ; Lung ; Lymphoma ; Male ; Melanoma ; Meninges ; Neoplasm Metastasis ; Occipital Lobe ; Paresis ; Parietal Lobe ; Prostate ; Protestantism ; Seizures ; Skull ; Stomach ; Vomiting

PURPOSE: To evaluate whether CT scanning is useful in differentiating the between endometriomas and other benign complex cystic adnexal masses, and in determining the method of treatment for each mass lesion. MATERIALS AND METHODS: In 54 cases (47 patients), we retrospectively analysed the CT findings of 20 pathologically-proven twenty endometriomas (bilateral in four cases), eight hemorrhagic functional cysts, two tubal ectopic pregnancies, eight tubo-ovarian abscesses (bilateral in two cases), ten serous cystadenomas (bilateral in one case), and six mucinous cystadenomas. Internal attenuation, the hyperdense portion, adhesion, and cul-de-sac obliteration were evaluated by CT scanning. RESULTS: Fourteen endometriomas (70%) showed a hyperdense portion, and in only two of these (10%), was a focal nodular hyperdense portion seen on pre-contrast CT scan (10% sensitivity, 100% specificity). Partial or complete cul-de-sac obliteration was identified in 11 patients (75%), while hemorrhagic functional cysts showed a hyperdense portion in four cases (50%) and were accompanied by partial cul-de-sac obliteration in two (25%). Two unruptured tubal ectopic pregnancies showed CT findings of unilateral hyperdense cystic masses of more than 60 HU. In all cases, tubo-ovarian abscesses were accompanied by thickening of the uterosacral ligament and deviation of thickened mesosalpinx (anterior deviation in 87.5% of patients). Serous and mucinous cystadenomas showed CT findings of hypodense masses (less than 20 HU) without adhesion or cul-de-sac obliteration, and this was helpful in differentiating cystadenomas from other benign cystic adnexal masses, including endometriomas. CONCLUSION: The evaluation by CT scanning of benign complex cystic adnexal masses with respect to the hyperdense portion and the presence or absence of cul-de-sac obliteration was usful in differentiating endometriomas from other lesions, and might be helpful in determining the method of treatment for each mass lesion.
Abscess ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Endometriosis* ; Female ; Humans ; Ligaments ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Asphyxia* ; Brain* ; Humans ; Infant* ; Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon*

A 59-year-old woman was scheduled to undergo a robot-assisted distal gastrectomy under general anesthesia. During the operation, the vital signs were maintained in normal range. After 7 hours of surgery, the pulse oxymeter graph became flat and the end tidal CO2 concentration suddenly decreased. Palpation of the carotid artery revealed no heart beat but the EKG continued to show sinus rhythm. Pulseless electrical activity (PEA) was diagnosed. An advanced cardiopulmonary life support protocol for PEA was immediately initiated, which included chest compressions and doses of IV cardiovascular drugs. However, in spite of continuous CPR, the heart wasn't recovered from the arrest. We experienced cardiac arrest for pulseless electrical activity during robot-assisted distal gastrectomy.
Anesthesia, General ; Cardiopulmonary Resuscitation ; Cardiovascular Agents ; Carotid Arteries ; Electrocardiography ; Female ; Gastrectomy ; Heart ; Heart Arrest ; Humans ; Hypovolemia ; Middle Aged ; Palpation ; Peas ; Reference Values ; Thorax ; Vital Signs