PURPOSE: The purpose of the experiment with the rabbit was to evaluate the effect of human amniotic membrane transplantation in the extraocular muscle surgery area after the operation. METHODS: Five millimeters resection of both superior rectus muscles was performed in eight rabbits. The left eye was served as a control, and the right eye was covered with human amniotic membrane at the site where the operation was performed. Each rabbit was graded according to the degree of adhesion. A histological comparison was done after enucleation. RESULTS: At one week after the operation, it was discovered that the inflammation of the human amniotic membrane transplantation site was suppressed, but at two weeks the human amniotic membrane transplantation site was significantly inflamed. However, the inflammation decreased at six weeks. CONCLUSIONS: This study shows that strabismus surgery with transplantation of human amniotic membrane may reduce postoperative inflammation and adhesion in strabismus surgery after one week. However, after two weeks the inflammation will increase and produce more postoperative adhesion. After six weeks there was no significant inflammation in comparison to the control group.
Amnion* ; Humans ; Inflammation ; Muscles ; Rabbits* ; Strabismus* ; Tissue Adhesions*

Perfusion scintigraphy has proved to be an essential part for the diagnosis of pulmonary thromboembolism. The wedge shaped perfusion defect extending to lung base is a highly probable finding of pulmonary embolism. Occasionally, great perfusion defects could be presented as a false positive finding under the circumstance of nonthromboembolic origin, such as neoplastic compression or invasion of pulmonary artery. We report an unusual case of massive perfusion defect resulting from pulmonary arterial compression by bronchogenic carcinoma. A 71-year-old man visited our hospital because of productive cough and was diagnosed as bronchogenic carcinoma. The perfusion scintigraphy showed unilateral total defect of lung, not accompanied by any clinical evidence of thromboembolism. A contrast enhanced computed tomogram showed heterogeneous mass shadow in left hilum, abutting to the descending aorta and compressing left main pulmonary artery. These findings suggested a nonembolic mechanism of perfusion defects which were produced by the neoplastic compression of pulmonary artery.
Aged ; Aorta, Thoracic ; Carcinoma, Bronchogenic* ; Cough ; Diagnosis ; Humans ; Lung* ; Perfusion Imaging ; Perfusion* ; Pulmonary Artery ; Pulmonary Embolism ; Thromboembolism

Gastrointestinal involvement has been reported to occur in about 5 to l0% of patients with lymphoma. The most common gastrointestinal site for a lymphoma is the stomach, followed by the small intestine and ileocecal region. When lymphoma is found in the esap us, generally it is with contiguous involvement of the gastric fundus, the cervical node, secondary to mediastinal lymph node compression, or a late manifestation of advanced desease. Such cases cannot be labeled as primary esophageal lymphoma. A search of the literature reveals that there have been about 20 or more published cases classified as esophageal lymphoma. However, more than ten cases are indistingishable from the case of distal esophageal involvement by gastric lymphoma. In 1935, Chiolero described a case of midesophageal stricture, which at autopsy was consistent with Hodgkin's disease for the first time. Berman reported an authentic case of primary histiocytic lymphoma confined to the lower esophagus. Only six or more cases were reported in literature until the present time. Here, a 30-year-old man with substernal discomfort was shown to have a mass lesion on the esophagus. The mass was proved to be malignant lymphoma on the histologic examination. This may be the first report dealing with spontaneous regression of maligant lymphoma of the esophagus possibly associated with the use of cimetidine.
Adult ; Autopsy ; Cimetidine ; Constriction, Pathologic ; Esophagus* ; Gastric Fundus ; Hodgkin Disease ; Humans ; Intestine, Small ; Lymph Nodes ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Stomach

Allergic response to common environmental agents has been regarded as a main pathogenetic mechanism of bronchial asthma. However, allergic sensitization (atopy) can not be detected in a siginificant number of adult asthmatic patients. The etiology of nonatopic asthma has not yet been defined. To evaluate the possible involvement of autoimmune response against bronchial mucosa in the pathogenesis of nonatopic asthma, we performed indirect immunofluorescence staining of fresh frozen human bronchial mucosa tissue using serum samples from patients with atopic and nonatopic asthma, healthy controls, and patients with systemic lupus erythematosus. On immunostaining, circulating IgG autoantibodies against bronchial mucosa were detected in 2 (9.1%) of 22 patients with nonatopic asthma and in none of 22 patients with atopic asthma and of 22 healthy controls. IgG autoantibodies from the two patients with nonatopic asthma predominantly stained the cytoplasmic membrane of basal cells in bronchial epithelium. Serum samples from 10 patients with systemic lupus erythematosus immunostained the nucleus of epithelial cells in whole layer of bronchial epithelium. This study showed the presence of circulating IgG autoantibodies against the bronchial epithelial cell in a small portion of patients with nonatopic asthma. Further studies may be necessary to evaluate the possible involvement of autoimmune mechanism in the pathogenesis of nonatopic asthma.
Asthma/immunology* ; Autoantibodies/immunology* ; Autoantibodies/blood ; Bronchi/immunology* ; Epithelial Cells/immunology ; Human ; Immunity, Mucosal/immunology ; Respiratory Mucosa/immunology*

BACKGROUND: As the number of elder patients grows, spinal anesthesia for such patients are increasing significantly. Any effort is needed to use the least anesthetic drug for maintaining the anesthesia while avoiding hazards of cardio-pulmonary complications. METHODS: American Society of Anesthesiologists physical status classification I and II, Forty five elderly patients (> or = 60 years) who received transurethral resection of the prostate or transurethral resection of the bladder tumor were allocated randomly into three treatment groups. The DMT 0.5 group was designed as with dexmedetomidine 0.5 microg/kg while the DMT 1.0 group has a 1 microg/kg intravenous injection over 10 min before anesthetic induction. The Control group was designed to get a normal saline. Each group was compared regarding the maximum sensory block level, extension of anesthesia, degree of motor block, level of sedation, VAS score and complications. RESULTS: There were no significant differences among the 3 treatment groups regarding the maximum level of sensory block and motor block. However, the duration of sensory block was significantly longer in DMT 1.0 group than in the control group (P = 0.045). Both DMT 1.0 group (median = 3, range = 2-6) and DMT 0.5 group (median = 3, range = 1-6) showed a mean value of 3-4 Ramsay sedation score, which resulted in more excessive sedation and significantly greater incidence of bradycardia compared to the control group. No complications such as hypotension, nausea, tremor, and hypoxia were found during this investigation. CONCLUSIONS: In elder patients, the DMT 1.0 group is effective in duration of sensory block and is superior in the aspect of prolonged duration of sensory block compared to the DMT 0.5 group.
Aged* ; Anesthesia ; Anesthesia, Spinal* ; Anoxia ; Appointments and Schedules* ; Bradycardia ; Classification ; Dexmedetomidine* ; Humans ; Hypotension ; Incidence ; Injections, Intravenous ; Nausea ; Prostate ; Tremor ; Urinary Bladder Neoplasms

We present a case of metameric arteriovenous malformation (AVM) in a neonate. The neonate appeared normal, except for a dimple and blue discoloration in the lower thoracic spine. Spinal ultrasonography revealed cutaneomeningiospinalangiomatosis in the thoracic spine. Spinal magnetic resonance imaging revealed a definite metameric AVM at the T10-T11 level and a cutaneous hemangioma at T11. The neonate was conclusively diagnosed with spinal metameric AVM at the T10-T11 level. The neonate was asymptomatic with no, abnormal physical or neurological complications, including urinary incontinence, fecal incontinence, or muscle weakness.
Arteriovenous Malformations* ; Fecal Incontinence ; Hemangioma ; Humans ; Infant ; Infant, Newborn* ; Magnetic Resonance Imaging ; Muscle Weakness ; Spinal Cord* ; Spine ; Ultrasonography ; Urinary Incontinence

PURPOSE: The efficacy of the artificial urinary sphincter(AUS) in treating sphincteric incontinence has been clearly demonstrated. We report on 20 years of experience using artificial sphincter implantation at a single institute. MATERIALS AND METHODS: The follow-up data for 37 patients who received AUS(AMS 800(TM)) implantation between 1987 and 2006 at Yonsei University were available for this study. We investigated various components of the medical records, such as the number of pads used per day, results of pre-operative urodynamic studies, operative and post-operative complications, and revision rate. RESULTS: Mean patient age was 35.6 years(range 15-64 years), and mean follow-up duration was 12.4 years(range 1.4-19.8 years). Of the 37 patients, 21 had neurogenic bladder, and 9 had traumatic injury. Other causes of incontinence included post-operative complications(4 patients) and congenital anomalies(3 patients). The cuffs were placed were in the bladder necks of 21 patients and in the bulbous urethrae of 16 patients. The average number of pads used daily decreased significantly from 6.2 to 1.2 after the operation, and 27 patients(72.9%) were able to maintain 'dry-up status' (number of pads used< or=1). A total of 32 artificial sphincters remained in place(86.4% survival rate), with 8 revisions(21.6%) required secondary to infection, mechanical failure, or urethral stone. CONCLUSIONS: AUS implantation is a safe and durable treatment for urinary incontinence in patients with intrinsic sphincter deficiency from various underlying diseases.
Follow-Up Studies ; Humans ; Medical Records ; Neck ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urinary Sphincter, Artificial ; Urodynamics

Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.
Adult ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Low Back Pain ; Neurologic Manifestations ; Outpatients ; Physical Examination ; Radiculopathy ; Zygapophyseal Joint

OBJECTIVES: The purpose of this study was to examine the influence of self-esteem and social support on the depression stati of some clinical nurses, and propose basic data for a depression care program. METHODS: Between March 31 and April 5 at 2006, a self-reporting questionnaire survey was administered to 200 nurses at a general hospital located in Gyeonggi-do. The Beck's Depression Inventory (BDI) was used to assess the subjects'depression stati. RESULTS: The average BDI score of the clinical nurses was 8.9+/-7.5, with 59% belonging to the normal category, 28% having mild depressive symptoms, and 13% with a moderate degree of depressive symptoms. The degree of depression was significantly increased in the clinical nurses with a lower self-esteem and less social support. The degree of depression was significantly increased in the clinical nurses with a lower self-esteem and less social support. According to a multivariate regression analysis, a significant association was found between self-esteem and social support in relation to the depression of clinical nurses. The effect of social support was found to not be significant in cases where the self-esteem was high: however, depression was significantly influenced by social support in cases where the self-esteem was low. CONCLUSION: Self-esteem and social support were observed to influence the depression stati of clinical nurses. Therefore, it is suggested that an increase in depression management programs is required to create systematic management to maintain an atmosphere of high self-esteem and close relationships to manage the depression of clinical nurses.
Atmosphere ; Depression* ; Gyeonggi-do ; Hospitals, General ; Questionnaires

BACKGROUND AND PURPOSE: Although plasmapheresis is becoming standard practice as a rescue therapy for neuromyelitis optica (NMO), evidence for the therapeutic efficacy of plasmapheresis is limited, and the effect of plasmapheresis on anti-aquaporin-4 (AQP4) levels in patients with NMO has not been reported. Here, our objective was to evaluate the clinical efficacy of therapeutic plasmapheresis and its effect on anti-AQP4 antibody levels in patients with NMO spectrum disorder (NMOSD). METHODS: We retrospectively reviewed the medical records of 15 patients with NMOSD who had 18 acute attacks and received plasmapheresis because they did not respond to high-dose intravenous methylprednisolone (IVMP) therapy. Anti-AQP4 antibodies were measured before and after plasmapheresis. The primary outcomes were functional improvements immediately and 6 months after plasmapheresis, and the secondary outcome was the change in anti-AQP4 antibody serum levels following plasmapheresis. RESULTS: Plasmapheresis following IVMP therapy led to significant improvement in 50% of the 18 attacks in 15 patients immediately after the procedure was completed, and in 78% (14 attacks) after 6 months. Plasmapheresis was generally well tolerated in all patients. Anti-AQP4 antibody serum levels declined significantly following plasmapheresis, to a mean of 15% of the preplasmapheresis levels. Lower scores on the visual outcome scale recorded before an attack were associated with significant immediate improvement upon the completion of plasmapheresis (p=0.03). CONCLUSIONS: Plasmapheresis following IVMP therapy effectively removed anti-AQP4 antibodies and was accompanied by a substantial improvement in the neurological disability of patients with NMOSD. Lower levels of pre-existing neurological damage may be associated with an improved acute response to plasmapheresis.
Antibodies ; Humans ; Medical Records ; Methylprednisolone ; Neuromyelitis Optica ; Plasmapheresis ; Retrospective Studies