To determine the effectiveness of unilateral medical rectus recession and lateral rectus resection in esotropia, surgical outcome was reviewed. We excluded paralytic strabismus, refractive esotropia and nonrefractive esotropia with high AC/A. Of 128 cases, 60 cases were male, 68 cases were female. At the amount of surgery, age distribution was from 11 month to 55 years. Preoperative angle of deviation was from 12 delta to 95 delta. We treated the patients with varying amount of unilateral medial rectus recession from 2.5mm to 8mm and unilateral lateral rectus resection from 2.5mm to 10mm. Following 31 months in average, 102(79.69%) showed successful alignment(orthporia +/-10 delta). The average amount of correction amount was 30.42 delta.
Age Distribution ; Esotropia* ; Female ; Humans ; Male ; Strabismus

To determine the effectiveness of unilateral medical rectus recession and lateral rectus resection in esotropia, surgical outcome was reviewed. We excluded paralytic strabismus, refractive esotropia and nonrefractive esotropia with high AC/A. Of 128 cases, 60 cases were male, 68 cases were female. At the amount of surgery, age distribution was from 11 month to 55 years. Preoperative angle of deviation was from 12 delta to 95 delta. We treated the patients with varying amount of unilateral medial rectus recession from 2.5mm to 8mm and unilateral lateral rectus resection from 2.5mm to 10mm. Following 31 months in average, 102(79.69%) showed successful alignment(orthporia +/-10 delta). The average amount of correction amount was 30.42 delta.
Age Distribution ; Esotropia* ; Female ; Humans ; Male ; Strabismus

Congenital arteriovenous(AV) communications of retinal circulation are rare developmental anomalies, exsisting alone or in association with ipsilateral vascular anomalies of the mid brain, cranial sinuses and skin. These are usually unilateral. We report a case of bilateral congenital arteriovenous communication. The right eye showed group III arteriovenous communication of retina with vitreous hemorrhage. The left eye showed group II arteriovenous communication combined with group I.
Brain ; Cranial Sinuses ; Retina ; Retinaldehyde ; Skin ; Vitreous Hemorrhage

Pyogenic vertebral osteomyelitis is rare. It most commonly occurs at the lumbar area and in the fifth to seventh decades of life. Most individuals present with back pain, abdominal pain, hip pain and meningeal syndrome. We experienced three cases of unusual patterns of pyogenic osteomyelitis. The first case developed after sepsis. The second case developed after open fracture and infection of other site. The third case was misdiagnosed as metastatic cancer. We present these cases with a brief review of literatures.
Abdominal Pain ; Back Pain ; Fractures, Open ; Hip ; Osteomyelitis ; Sepsis ; Spondylitis*

No abstract available.
Heart Defects, Congenital* ; Plasma*

PURPOSE: Knee IVIR images were repeatedly obtained after intravenous administration of gadopentetate dimeglumine to evaluate the arthrographic effect and to determine the optimal scan timing and technique. MATERIALS AND METHODS: Sagittal Tl-weighted (650/15) sequences were repeated before and after intravenous gadolinium enhancement in 26 patients who were divided into exercise (14/26) and nonexercise (12/26) groups. Fourteen patients in exercise group were allowed to move the affected knee joint actively for 10 minutes immediately after the first post-enhancement scan and before repeating scans. The signal intensities in central and peripheral portions of the joint were measured and compared between these two groups. RESULTS: In all cases, enhancement of joint fluid began at peripheral portion and progressed toward central portion. The diffusion rate in exercise group was far faster than that in nonexercise group and homogeneous arthrographic image was revealed within 10 minutes after completion of joint movement. The arthrographic effect continued and the rate of signal decrease was quite slow. CONCLUSION: MR arthrographic image of knee joint can be obtained within 10 minutes after completion of a few minute exercise following intravenous injection of gadopentetate dimeglumine. Intravenous MR arthrography is expected to become an useful method as a convenient alternative to direct MR arthrography.
Administration, Intravenous ; Arthrography* ; Diffusion ; Gadolinium ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Joints ; Knee Joint ; Knee*

p73, a first p53 relative, has been identified at chromosome 1p36, a region that is deleted in variety of human cancers. This protein shares strong homology with p53 protein, suggesting functional similarities with p53. Indeed, p73 can activate p53 downstream genes inducing apoptosis or growth arrest in tumor cells lacking p53. This phenomenon leads us to investigate the function of p73 in ovarian cancer because aberrant p53 was very frequently found in this cancer. We hypothesize that DNA damaging agents trigger p53 dependent apoptotic pathway through p73 instead of p53 in ovarian cancer having aberrant p53. We selected SKOV3 ovarian cancer cell line having no p53 gene and treated this cell line with cisplatin. After the treatment, we examined the transcriptional level of p73 and p21. Moreover, to identify whether the status of p53 influence to the function of p73, we performed same experiment after inserting adenovirus mediated p53(Avp53) into cell line. We detected significantly increased transcripts of p73 whcn treated with cisplatin. But treated with Avp53 or combined treatment with cisplatin, the transcriptional levels were not changed. These data suggest that overexpression of p73 may be important to trigger apoptotic pathway when the p53 gene is lost, but not so important in cells having normal p53.
Adenoviridae ; Apoptosis ; Cell Line* ; Cisplatin ; DNA ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Ovarian Neoplasms*

If hypertensive emergencies are left untreated, multiple damages on heart, brain and kindney can develop. So rapid control of blood pressure within safty with effective antihypertensive agents is mandatory. For the comparison of antihypertensive effects among hydralazine (IV or IM), clonidine (IV), and nifedipine (sublingual) in hypertensive emergency, which were frequently used in our hospital, we performed propective study with hypertensive emergency patients(243 cases) who visited emergency room from Oct. 1986 until Aug. 1987. The results are as follows ; 1) For 58 patients who recieved hydralazine (IV or IM), initial mean arterial blood pressure(MAP) was 167.2+/-21.5mmHg and 15 minutes later 138.9+/-24.4mmHg, 45 minutes later 141.7+/-21.1mmHg, 90 minutes later, 133.9+/-26.6mmHg and, respectively. For 55patients who recived clonidine(IV), initial MAP was 164+/-21.9mmHg and 15minytes later 137.4+/-18.9mmHg, 45 minutes later 127.5+/-34.9mmHg, respectively. For 130 patients who recived nifedipine(sublingual), initial MAP was 159.8+/-21.4mmHg and 15 minutes later 143.0+/-22.8mmHg, 45 minutes later 127.5+/-21.1mmHg, 90 minutes later 119.3+/-20.0mmHg, respectibely. 2) Pulse rate showed 12.9% increase afer administration of hydralazine, 15.8% decrease in clonidine, 5.6% increase in nifedipine, respectively. 3)Severe reduction of blood pressure(systolic BP<130mmHG) after administration of following antihypertensive agents was found. i.e., hydralazine 5.2%, clonidine 1.8%, nifedipine 1.5%, respectively. 4) In 4 cases(6.9%) out of the 58 cases using hydralazine, 3 cases(5.5%) out of the 55 cases using clonidine, 9 cases(6.9%) out of the 130 cases using nifedipine, acute paradoxic hyertensive effects were observed.
Antihypertensive Agents ; Blood Pressure ; Brain ; Clonidine* ; Emergencies* ; Emergency Service, Hospital ; Heart ; Heart Rate ; Humans ; Hydralazine* ; Nifedipine*

BACKGROUND: The fundamental responsibility of an anesthesiologist is to maintain adequate ventilation and to supply oxygen in the face of unexpected difficulties with tracheal intubation. The laryngeal mask airway (LMA) has been used as a ventilatory device familiarly for routine or difficult intubation but it has been hard to intubate with it the larger than 6 mm internal diameter (ID) endotracheal tube (ET). The intubating LMA is a new prototype of the LMA; it is partey composed of an anatomically curved rigid airway tube of ID 13 mm for larger ET tube insertion (such as ID 9.0 mm) into a 15 mm connector at its outer end which is fixed permanently to a laryngeal mask. This study was performed to evaluate the technique and facility of the intubating LMA as an apparatus for endotracheal intubation when used by an inexperienced anesthesiologist. METHODS: With informed consent, 43 patients of ASA physical status I or II were selected. Either lubricated polyvinyl chloride or an armored wire tube of ID 7.0 or 7.5 mm was intubated through the No. 4 or 5 intubating LMA. During this procedure, we observed the technical method and success rate, and recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) changes. 24 hours after each operation, we observed subjective symptoms such as sore throat, hoarseness, and difficult in swallowing. RESULTS: The success rate of intubating LMA insertion was as follows: 33 (77%) patients were successed on first attempt, 6 (14%) patients on second attempt, 4 (9%) patients on third attempt. The insertion of the intubating LMA was carried out facilely without another maneuver such as neck extension or tongue expulsion. The success rate of tracheal intubation was 86.1%. In 32 (74.5%) patients there was easy intubation, but 5 (11.6%) patients required more adjustment and the failure rate with them was 6 (13.9%). SBP, DBP were only increased by endotracheal intubation through the intubating LMA, but HR was significantly increased during both insertion and intubation (p < 0.05). Postoperative sore throat was complained of in 11 patients; hoarseness in 1 patient. CONCLUSIONS: Insertion of the intubating LMA is facile due to the absence of need for the maneuvers of neck motion or tongue expulsion. The intubating technique through the intubating LMA is a relatively rapid and easy method, but it requires technical experience which in some cases is lacking in inexperienced anesthesiologists.
Blood Pressure ; Deglutition ; Heart Rate ; Hoarseness ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngeal Masks ; Neck ; Oxygen ; Pharyngitis ; Polyvinyl Chloride ; Tongue ; Ventilation

BACKGROUND: The fundamental responsibility of an anesthesiologist is to maintain adequate ventilation and to supply oxygen in the face of unexpected difficulties with tracheal intubation. The laryngeal mask airway (LMA) has been used as a ventilatory device familiarly for routine or difficult intubation but it has been hard to intubate with it the larger than 6 mm internal diameter (ID) endotracheal tube (ET). The intubating LMA is a new prototype of the LMA; it is partey composed of an anatomically curved rigid airway tube of ID 13 mm for larger ET tube insertion (such as ID 9.0 mm) into a 15 mm connector at its outer end which is fixed permanently to a laryngeal mask. This study was performed to evaluate the technique and facility of the intubating LMA as an apparatus for endotracheal intubation when used by an inexperienced anesthesiologist. METHODS: With informed consent, 43 patients of ASA physical status I or II were selected. Either lubricated polyvinyl chloride or an armored wire tube of ID 7.0 or 7.5 mm was intubated through the No. 4 or 5 intubating LMA. During this procedure, we observed the technical method and success rate, and recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) changes. 24 hours after each operation, we observed subjective symptoms such as sore throat, hoarseness, and difficult in swallowing. RESULTS: The success rate of intubating LMA insertion was as follows: 33 (77%) patients were successed on first attempt, 6 (14%) patients on second attempt, 4 (9%) patients on third attempt. The insertion of the intubating LMA was carried out facilely without another maneuver such as neck extension or tongue expulsion. The success rate of tracheal intubation was 86.1%. In 32 (74.5%) patients there was easy intubation, but 5 (11.6%) patients required more adjustment and the failure rate with them was 6 (13.9%). SBP, DBP were only increased by endotracheal intubation through the intubating LMA, but HR was significantly increased during both insertion and intubation (p < 0.05). Postoperative sore throat was complained of in 11 patients; hoarseness in 1 patient. CONCLUSIONS: Insertion of the intubating LMA is facile due to the absence of need for the maneuvers of neck motion or tongue expulsion. The intubating technique through the intubating LMA is a relatively rapid and easy method, but it requires technical experience which in some cases is lacking in inexperienced anesthesiologists.
Blood Pressure ; Deglutition ; Heart Rate ; Hoarseness ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngeal Masks ; Neck ; Oxygen ; Pharyngitis ; Polyvinyl Chloride ; Tongue ; Ventilation