No abstract available.
Lithotripsy* ; Ureter*

No abstract available.
Precursor Cell Lymphoblastic Leukemia-Lymphoma*

The treatment of subtrochanteric fracture of the femur is one of the most difficult problems. Open reduction and rigid internal fixation is the choice of treatment nowaday. Zickel(1967) reported a new fixation device to treat subtrochanteric fracture of the femur which was designed to provide more rigid fixation in both major fragments, control angulation and rotation, and permit earlier ambulation. The authors reviewed 14 cases of subtrochanteric fracture of the femur which were treated with Zickel-Nail from June, 1979 to November, 1980. The results were obtained as follows: 1. The average age of patients was 44.7 years. 2. In 10 cases without associated injury, parallel-bar walking was possible within postoperative one week. In 8 cases of these, crutch walking with partial weight bearing was possible within postoperative 2 weeks. In others, there were some benifits in bed-side care because of rigid internal fixation which was provided with Zickel-Nail. 3. There were no significant postoperative complicatons except 3 cases of technical error. 4. There was no limb shortening except one case which was old complicated nonunion with severe osteoporosis and had a new fracture during Zickel-Nail procedure. 5. There were no differences in radiological bony union between pathologic fracture and traumatic fracture except one case with liver cell carcinoma of subtrochanteric region of the femur which we could not do follow-up study.
Carcinoma, Hepatocellular ; Extremities ; Femur ; Follow-Up Studies ; Fractures, Spontaneous ; Hip Fractures ; Humans ; Osteoporosis ; Walking ; Weight-Bearing

BACKGROUND: The perfect preanesthetic medication and its ideal route of administration are still debated. Transmucosal administration of midazolam has been of interest because of the rapid, reliable onset of action, predictable effects and avoidance of injections. Because many medications are well absorbed from the mucosa, we conducted a randomized, prospective, blinded study to compare acceptance and efficacy of intranasal and sublingual administration of midazolam as a preanesthetic medication in children. METHODS: One hundred twenty eight patients aged 0.5-12year were stratified by age: 38 infants and toddlers, 0.5-3yr; 48 preschoolers, 3.1-7yr; and 42 school age, 7.1-12yr. They were randomized to received 0.2 mg/kg of midazolam in the nose or under the tongue. Hemoglobin oxygen saturation by pulse oximetry and sedation score were recorded before drug administration, at 2.5min intervals for 15min, at separation from parents and during induction with enflurane in O2. Retention time of sublingual drug and duration of crying were recorded. RESULTS: The incidence of crying at the time of administration of midazolam was greater following intranasal compared with sublingual administration(60% vs 17%, p<0.05). Within age groups, only infants and toddlers showed a significant difference in the incidence of crying between treatment groups. Significant changes in sedation occured in both groups from 2.5min after administration. CONCLUSIONS: Sublingual midazolam is better accepted than intranasal midazolam as a preanesthetic sedative in children.
Administration, Mucosal ; Administration, Sublingual ; Child ; Crying ; Enflurane ; Humans ; Hypnotics and Sedatives ; Incidence ; Infant ; Midazolam* ; Mucous Membrane ; Nose ; Oximetry ; Oxygen ; Parents ; Preanesthetic Medication* ; Premedication ; Prospective Studies ; Tongue

PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
Cardia ; Causality ; Cause of Death ; Drug Therapy* ; Granisetron* ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Nausea* ; Neoplasm Metastasis ; Platinum* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Vomiting*

This study was carried out to evaluate the effect of electrocauterization on corneal astigmatism after cataract operation with temporal incision. Forty-two eyes of patients undergoing routine phacoemulsification with one piece type polymethymethacrylate(PMMA) posterior chamber lens implantation with 6.0mm temporal scleral pocket incision and sutureless method by one surgeon were randomly selected Corneal astigmatism was evaluated for postoperative 3 months and analyzed by Cravy`s vector method. Both groups(electrocauterization group and no electrocauterization group) showed slight with-the-rule change of corneal astigmatism till postoperative 3 months and electrocauterization group showed +0.31D at postoperative 3 months but these differences were not statistically significant(student`s t-test: p=1.10). This results demonstrate that the scleral electrocauterization at temporal incision site induced more with-the-rule change than no cauterization group.
Astigmatism* ; Cataract* ; Cautery ; Humans ; Phacoemulsification

To evaluate the change of corneal sensation following LASIK, the corneal sensation of 26 eyes(14 patients) were examined before and 1 week, 2 week, 1 month, 2 month, 3 month, and 6 month after LASIK. The corneal sensation was measured on the following points of the center, temporal, inferior, nasal, and superior side with an esthesiometer of Cochet-Bonnet type. Each measurement of side point was taken 3mm apart from corneal center. The eyes were divided into two groups; group I was eyes with a corneal ablation depth under 100micrometer and group II was those with a value over 100micrometer. Corneal sensations in all cases were not recovered to the level of preoperation until 6 month after LASIK. The pattern of recovery was indifferent among the various points on the cornea except for the hinge side, which has shown more rapid recovery than any other area. The recovery speed between the hinge side and other areas was statistically significant(P<0.05). A decrease of corneal sensation was more prominent in group I than group II. With these results, we are able to suggest that lamellar cut of the cornea by LASIK procedure makes a damage on the corneal sensation and the depth of ablation might cause an influence on the amount of loss and recovery of the corneal sensation.
Cornea ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Sensation*

PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

We evaluated the result of treating myopia and compound myopic astigmatism in 50 eyes using the SCMD turbokeratotome and Visx 20/20 excimer laser with vision key card system. Manifest and cycloplegic refraction, uncorrectedand spectacle corrected visual acuity, corneal topography, pachymetry, slit lamp microscopy, fundus examination, and applanation tonometry were recorded preoperatively and at 1 week, 1, 2, 3 and 6 months postoperatively. The mean spherical epuivalent was changed from -9.1+/-2.47D to -1.37+/-1.28D at 3 month after surgery. 93.3% of eyes had uncorrected visualacuity of 20/40 or better at 3 months follow-up. No eye had visually significant ecntral cornealhaze. Complications such as over- or under correction, interface metallic debris, astigmatism, corneal erosion, incomplete flap, and total cutted flap were occurred. Conclusively, LASIK has good resuls but it is not complication-free procedure, and there is definitely a learning curve.
Astigmatism ; Corneal Topography ; Follow-Up Studies ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Learning Curve ; Manometry ; Microscopy ; Myopia ; Visual Acuity