No abstract available.
Accidents, Traffic*

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

PURPOSE: We report the treatment and prognosis of two patients who experienced pain in their face associated with skin lesions and acute decreased visual acuity and were diagnosed with optic neuritis caused by the herpes zoster virus. CASE SUMMARY: Two patients were diagnosed with herpes zoster ophthalmicus after experiencing an acute decrease in visual acuity and were sent to our clinic for examination. On ophthalmic evaluation, the results were positive for relative afferent pupillary defect (RAPD) and showed abnormal VEP levels. On MRI T1, one case showed a high signal along the optic nerve sheath. Both patients with optic neuritis were treated with Acyclovir (Zovirax(R), GlaxoSmithKline, U.K.), which is an antiviral drug, at a dose of 10 mg/kg every 8 hours for 5 days, and a combination of prednisolone at a dose of 250 mg every 6 hours. After general therapy, they took Acyclovir (250 mg) orally 3 times daily for 14 days, with steroids (40 mg), and decreased the dosage after two weeks. We saw no improvement of visual acuity in either case, which still showed RAPD. CONCLUSIONS: Optic neuritis secondary to herpes zoster ophthalmicus rarely occurs, but it is difficult to treat and has a poor prognosis. We should keep in mind that optic neuritis can occur in patients who were diagnosed with herpes zoster ophthalmicus.
Acyclovir ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Herpesvirus 3, Human ; Humans ; Optic Nerve ; Optic Neuritis ; Prednisolone ; Prognosis ; Pupil Disorders ; Skin ; Steroids ; Visual Acuity

No abstract available.
Child* ; Glomerulonephritis, Membranoproliferative* ; Humans

Twenty-five patients with unstable fracture or fracture-dislocation of the thoracolumbar and lumbar spines were treated with Cotrel-Dubousset instrumentation. Internal fixation was done in two ways; long rodding in seventeen patients and short rodding in eight. Short segment posterolateral or posterior autogenous iliac bone graft was done in all cases. The amount of correction of the collapsed anterior vertebral body height and the local kyphotic angle at the immediate post-operation were similar between the two groups, but loss of correction at last follow-up was more severe in the short rodding group. Instrument failure was also more common in the short rodding group. In conclusion, it was found that short segment stabilization of spine fractures with Cotrel-Dubousset instrument can effectively reduce fracture but can not maintain reduction until fusion. Therefore, long rodding was reconfirmed to be the better method of stabilization of the thoracolumbar and lumbar spines fractures.
Body Height ; Follow-Up Studies ; Humans ; Methods ; Spine ; Transplants

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation

Eight patients with recurrent oligodendroglioma were treated with 1.3-bis(2-chloroethyl) nitrosourea(BCNU) and CDD continuous infusion chemotherapy. They were 5 with benign oligodendrogliomas and 3 with anaplastic oligodendrogliomas. All the recurrent tumors had been treated with surgery and radiotherapy. Four patients had already received chemotherapy with ACNU. Seven of them showed response to continuous infusion chemotherapy. The time from the response to progression was 15 to 67 weeks. No severe complication of the chemotherapy was found. In conclusion, BCNU-CDDP continuous infusion chemotherapy is an effective treatment modality in recurrent oligodendrogliomas.
Carmustine ; Drug Therapy* ; Humans ; Nimustine ; Oligodendroglioma* ; Radiotherapy

PURPOSE: To evaluate the short-term effect and safety of intravitreally injected bevacizumab in patients with macular edema (ME) caused by retinal vein occlusion (RVO) and diabetic macular edema (DME). METHODS: We retrospectively evaluated 59 eyes of 51 patients, 29 with ME caused by RVO and 30 with DME, who received intravitreal injection of bevacizumab. Fifty-one consecutive patients (59 eyes) with ME associated with RVO and DME were treated with intravitreal injections of 1.25-2.5 mg (0.05-0.1 ml) of bevacizumab. Ophthalmic evaluation was performed at baseline and at 1, 3, 6 months after each injection. Clinical evidence of toxicity and complications, changes of visual acuity with an ETDRS chart (LogMAR), and central macular thickness (CMT) using optical coherence tomography (OCT), were evaluated. RESULTS: The follow-up period was 7.3 months (7.3+/-0.31) and the mean number of injections was 1.2. The baseline mean LogMAR was 1.06+/-0.53 and mean CMT was 479.6+/-160.4 micrometer. At 1, 3 and 6 months, the mean LogMAR was 0.90+/-0.52, 0.80+/-0.39 and 0.78+/-0.39, respectively, and the mean CMT was 316.9+/-86.7 micrometer, 281.1+/-67.4 micrometer and 278.4+/-64.6 micrometer, respectively. No adverse incidents were observed, including cataract, retinal detachment, vitreous hemorrhage, and endophthalmitis, although transient increased intraocular pressure was observed. CONCLUSIONS: Intravitreal bevacizumab injections are safe and effective in ME caused by RVO and DME.
Antibodies, Monoclonal, Humanized ; Cataract ; Endophthalmitis ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Retinal Detachment ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitreous Hemorrhage ; Bevacizumab

BACKGROUND: Hemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB) is mainly attributed to impaired filling and diastolic dysfunction. An elevated ratio of the mitral velocity to the early-diastolic velocity of the mitral annulus (E/e' > 15) is a relatively new indicator of diastolic function, and this was reported to be associated with impaired hemodynamics during OPCAB. We investigated the efficacy of milrinone on the perioperative hemodynamics and short term outcomes of patients with an E/e' > 15 and who underwent OPCAB. METHODS: The patients were randomly allocated into either group C (control, n = 31) or group M (n = 31) and they were treated with the same amount of either normal saline or milrinone (0.5 microg/kg/min) without bolus loading after completion of internal mammary artery harvest until the end of operation. Hemodynamic measurements were recorded after the induction of anesthesia (T1), 5 min after starting each distal anastomosis of the left anterior descending artery (T2), left circumflex artery (T3) and right coronary artery (T4), and 5 min after sternum closure (T5). RESULTS: The mixed venous oxygen saturation (SvO2) was lower through T2-T4 compared to the baseline value in both groups, while the degree of the decrease was significantly less in group M than that in group C. The other hemodynamic variables, the operative data and the postoperative outcomes were similar between the two groups. CONCLUSIONS: Intraoperative infusion of milrinone did not significantly improve the perioperative hemodynamics and the subsequent short term outcomes for the patients with preexisting diastolic dysfunction as represented by an elevated E/e' value, although it reduced the degree of decrease of the SvO2 during OPCAB.
Anesthesia ; Arteries ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Hemodynamics ; Humans ; Mammary Arteries ; Milrinone ; Oxygen ; Sternum

No abstract available.
Foreign Bodies* ; Pulmonary Artery*