No abstract available.
Arthroplasty* ; Knee*

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

PURPOSE: To identify the polymorphism in the regulatory region of trabecular meshwork inducible glucocorticoid response(TIGR) gene and evaluate the association of it with glaucoma. METHODS: 5'regulatory region of TIGR gene of 101 normal persons and 91 unrelated glaucoma patients were analyzed by DNA sequencing and restriction enzyme digestion. To know the possible effects of the polymorphism on the transcription rate of TIGR gene, electrophoretic mobility shift assay and luciferase reporter gene assay were performed with cultured cells, and their extracts of trabecular meshwork and ciliary body in which the gene was expressed. RESULTS: Of the 480 bp examined, G to A transition(G-241A) located at 241 bp upstream from transcription start site was identified and its frequency of occurrence was proved to be higher in steroid induced glaucoma patients(18.9%) compared with that in normal population(8.9%), POAG(8.3%) and normal tension glaucoma patients(6.7%, P<0.05). In mobility shift assay, the G-241A probe was proved to have affinity to some DNA-binding proteins and its affinity was revealed to be two times stronger than that of normal sequence. The luciferase activities, however, were observed to be similar in cells transfected with vectors having normal promoter sequence or G-241A containing one. CONCLUSION: The result suggest that G-241A itself is not a cause of steroid-induced glaucoma but is in linkage disequilibrium with the actual causes of the disease.
Cells, Cultured ; Ciliary Body ; Digestion ; DNA-Binding Proteins ; Electrophoretic Mobility Shift Assay ; Genes, Reporter ; Glaucoma* ; Humans ; Linkage Disequilibrium ; Low Tension Glaucoma ; Luciferases ; Regulatory Sequences, Nucleic Acid* ; Sequence Analysis, DNA ; Trabecular Meshwork ; Transcription Initiation Site

We performed 70 proceudres of transarterial chemoembolization (TAE) through extrahepatic collateral vessels (n=27) or parasitic feeders (n=18) in 45 hepatocellular carcinoma patients. The collaterals developed after interruption of the hapatic artery due to repeated TAE(n=17), surgical ligation(n=7) and primary celiac occlusion (n=3). Radiologic findings suggesting the existence of parasitic or collateral supply for hepatocellular carcinoma were 1) a focal defect of Lipiodol retention on CT or plain film after TAE via the hepatic artery, 2) dilated and tortuous vessels around the mass on angiography, 3) persistent elevation of the level of serum alpha fetoprotein or continuous clinical symptoms in spite of sufficient devascularization of the tumor via the hepatic artery, and 4) radiological findings of direct invasion into adjacent organ. The sites of the catheter placement were the inferior phrenic artery (n=19), omental branches (n=16), periportal collaterals (n=6), pancreaticodenal arcade (n=3), gastroduodenal artery (n=3), internal mammary artery (n=2), intercostal artery (n=2), lateral thoracic artery (n=1), bronchial artery(n=1), and colic branches(n=1). Masses feeded by the inferior phrenic and chest wall collaterals were usually located at the dome area of the liver, and the omental and gastroduodenal collaterals developed in the masses located at the inferior tip of the liver. After TAE via collateral vessels, 37 patients underwent follow-up study. In 18 cases(48%), the tumor favorably responded to TAE. Specific complications of collateral TAE were epigastric soreness (n=10), severe shoulder pain (n=4), and embolization of the spinal artery during embolization through the intercostal artey (n=1). In conclusion, various extrahepatic collaterals are important alternative or additional routes for effective chemoembolization in patients with advanced hepatoma, and early recognition of the parasitic supply and the effort to perform TAE via collaterals is very important for effective management of the patients with the hepatoma.
alpha-Fetoproteins ; Angiography ; Arteries ; Carcinoma, Hepatocellular* ; Catheters ; Colic ; Ethiodized Oil ; Follow-Up Studies ; Hepatic Artery ; Humans ; Liver ; Mammary Arteries ; Shoulder Pain ; Thoracic Arteries ; Thoracic Wall

Two kinds of copper-pure and 70% dilute alloy suspension were introduced into the vitreous of albino rabbits, and electron microscopical observation was carried out on the retinal tissue after several periods from 1 day up to 60 days. Major changes are as follows: 1. Early response of rabbit retina with pure copper foreign body exhibited severe and diffuse destruction with much deposition of particles mainly in nerve fiber layer. The influence of 70% copper alloy to the retinal tissues tended to demonstrate mild, localized and delayed in occurrence. 2. In the nerve fiber layer where the tissue disintegration took place Muller cell demonstrated the features of mitosis and proliferation. Including this rare incidence, it is possible to conclude that Muller cell proliferation occur in any part of the retina if the condition allows. 3. Cytoid bodies mainly consisting with glycogen aggregates within the Miiller cell processes in nerve fiber layer was one of prominent pictures in early stage. 4. Muller cells took an important role in reparative process replacing the destructive portion of the retinal cells with the extension of the same cells beyond the external limiting membrane toward the choroid. 5. At the late stage, the Muller cells contained abundant filaments replacing the reduced number of smooth surfaced endoplasmic reticulum and other organells. That implicats the enhancement of supportive mechanism at the occasion of the disintegration of retinal tissue prolonged. 6. A relatively early sign was active phagocytosis of retinal pigment epithelial cells engulfing the reminiscent fragment of ouer pigment of visual cells.
Alloys ; Cell Proliferation ; Choroid ; Copper ; Endoplasmic Reticulum ; Ependymoglial Cells ; Epithelial Cells ; Foreign Bodies ; Glycogen ; Incidence ; Membranes ; Mitosis ; Nerve Fibers ; Phagocytosis ; Rabbits ; Retina* ; Retinaldehyde

We report a case of hypertrophic lupus vulgaris in the right knee of an 18-year-old man. The lesion, an erythematous scaly hypertrophic plaque, had grown for 12 years without any trestment leaving an atrophic scar. Histopathologically, the lesion consisted of s granuloma composed of epithelioid cells and lymphocytes. Lsboratory examinations including hematology, blood chemistry, urinalysis, and chest roentgenography were normal. The Mantoux test was strongly positive. Treatment with anti-tuberculosis medieation resulted in a good response.
Adolescent ; Chemistry ; Cicatrix ; Epithelioid Cells ; Granuloma ; Hematology ; Humans ; Knee ; Lupus Vulgaris* ; Lymphocytes ; Radiography ; Thorax ; Urinalysis

From January to September 1995, eleven eyes of eleven patients with medically uncontrollable glaucoma or previously failed filtering cases underwent installation of Baerveldt implant. Seven men and four women were enrolled into this study,, and meand age of the patients was 41.7+/-22.9 years (range, 2-65years). Nine eyes had neovascular glaucoma (diabetic retinopathy) in six eyes, Coats` disease in one, central tetinal vein occlusion in one, other in one of nine eyes), two eyes had secondary glaucoma after penetrating keratoplasty. The mean follow-up period was 10.6+/-8.4 months (range, 2-22 months), and preoperative intraocular pressure(IOP)s averaged 54.8+/-16.0mmHg range, 26-76mmHg) were lowered to a mean of 14.7+/-3.1mmHg (range, 12-40mmHg) postoperatively. Ten eyes achieved final IOPs between 6 and 14mmHg without medication, and one eye was eviscerated. Postoperative complications included hyphema in five eyes (45.5%), flat anterior chamber in two eyes(18.1%), obstruction of the tube in two eyes(18.1%), and cataract progression in two eyes(18.1%) of the eleven eyes. We installed Baerveldt implant in eleven recalcitrant glaucomas, and obtained successful result of 90.0% without serious complication. In conclusion, although Baerveldt implant is large, it is easier to implant an requires less extensive conjunctival incision than other large implants, and it afforded a good IOP control.
Anterior Chamber ; Cataract ; Female ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Keratoplasty, Penetrating ; Male ; Postoperative Complications ; Veins

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

Aspergillus is usually found in the human upper respiratory tract, or soil, and causes sinusitis for the immunocompromised or immunocompetent hosts. Sometimes it extends to the cavernous sinus, internal carotid artery or the orbit and results in severe complications. We diagnosed cavernous sinus thrombosis and sphenoid sinusitis by Aspergillus in a 58-year-old woman who visited our clinic for headache, left eyeball pain, and proptosis. We treated the patient with endoscopic ethmoidectomy, sphenoidectomy and antifungal therapy with Amphotericin B. During one year of follow-up, we found no evidence of recurrence. Cavernous sinus thrombosis by Aspergillus is a rare disease, and can be treated successfully without recurrence with early diagonosis and vigorous treatment.
Amphotericin B ; Aspergillus* ; Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Exophthalmos ; Female ; Follow-Up Studies ; Headache ; Humans ; Middle Aged ; Orbit ; Rare Diseases ; Recurrence ; Respiratory System ; Sinusitis ; Soil ; Sphenoid Sinus ; Sphenoid Sinusitis

Pulsatile ocular blood flow(POBF) System can measure the ocular blood flow easily and reliably. We attempted to investigate if oral calcium-channel blockers such as nifedipine and verapamil used for treatment of normal tension glaucoma increase the ocular blood flow in normal eyes by using above instrument. Twelve normal volunteers who have no ocular and systemic disorder history were involved in this study, and their ocular blood flow, intraocular pressure, systolic and diastolic blood pressure and pulse rate were measured. We performed the same study for 14 normal volunteers using verapamil. Systolic and diastolic blood pressures were decreased significantly after administration of calcium-channel blockers(P<0.05), but ocular blood flow did not change with administration of calcium-channel blockers(P>0.05). The intraocular pressure did not vary after administration of verapamil, but elevated in mean by 1.1mmHg after administration of nifedipine(P<0.05). Our study showed oral calcium-channel blockers, nifedipine and verapamil, did not increase the ocular blood flow in normal subjects with use of POBF.
Blood Pressure ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Healthy Volunteers ; Heart Rate ; Intraocular Pressure ; Low Tension Glaucoma ; Nifedipine ; Verapamil