No abstract available.
Extremities* ; Ilizarov Technique*

PURPOSE: To investigate the prevalence rate and risk factors for anterior polar cataract. METHODS: We examined the frequency of anterior polar cataract in 603 patients who had undergone cataract operation in the Department of Ophthalmology from July 1999 to July 2000. Moreover, we evaluated retrospectively the risk factor of 628 anterior polar cataracts and compared with that of 302 non-anterior polar cataract as well as with that of 552 non-cataract persons as a control from March 1995 to December 2000. This study defined risk factors related to the cataract formation as birth place, residence, occupation, sun-light exposure, drinking, smoking, systemic disease, long-term used drugs, family history, ocular trauma, glasses, and feminine parity. RESULTS: The prevalence rate of anterior polar cataract was 16.1% in total cataract patients, it had male of 81.4% and female of 18.6%. Average age of anterior polar cataract patients was 51.9 years; below fifty years was 44 patients (45.4%), 50~59 years 28 patients (28.9%), 60~69 years 16 patients (16.5%), over 70 years 9 patients (9.3%). Our findings for multivariate analysis that ocular trauma, intraocular disease in male and diabetes in female were significantly associated with anterior polar cataract. CONCLUSIONS: In conclusion, 16.1% of total cataract patients had anterior polar cataract; 81.4% was male and 45.5% was below fifty years of age.
Cataract* ; Drinking ; Epidemiologic Studies* ; Eyeglasses ; Female ; Glass ; Humans ; Male ; Multivariate Analysis ; Occupations ; Ophthalmology ; Parity ; Prevalence ; Residence Characteristics ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginally administered misoprostol(PGE1) versus dinoprostone(PGE2) for labor induction in a prospective controlled trial. METHOD: One hundred eleven patients for labor induction (including preterm rupture of membranes) were randomly assigned to receive either misoprostol 50microgram or dinoprostone 3mg intravaginally. The interval of doses was 8 hours after first dose, with a potential maximum of six dose until active labor pain was achieved. RESULTS: Among 111 patients enrolled, 55 were randomized to receive misoprostol 50microgram and 56 to receive dinoprostone 3mg with every 8 hours interval intravaginally. There were no significant differences in demographic characteristics except in Bishop score(3.81+/-1.52 vs 4.38+/-1.29, P<0.05). There were no significant differences in indications for labor induction. The interval of induction to delivery was shorter in the misoprostol group(750.8+/-518.8min) than in the dinoprostone group(1264.1+/-730.7min). Delivery within 24 hours after administration occurred more often in the misoprostol group than in the dinoprostone group (86.3% vs 65.2%, P<0.05). More than two doses for completion of delivery were frequent in dinoprostone group(36.96% vs 9.8% in misoprostol group, P<0.05). Additional Oxytocin augmentation was needed more commonly in the misoprostol group(3.64%) than in the dinoprostone group(14.29%)(P<0.05), but no significant differences were noted between two groups in total oxytocin doses and indications. Tachysystole occurred more often in the misoprostol group (12.73% vs 1.79% in the dinoprostone, P<0.05) Precipitating delivery occurred more commonly in the misoprostol group(21.82% vs 7.14% in the dinoprostone group, P<0.05). No differences in the cesarean section rate, fetal heart rate abnormalities, hyperstimulation syndrome, meconium staining, fetal outcome (Apgar score at 1 and 5 minutes, birth weight), and marternal outcome (nausea and vomitting, postpartum bleeding) were noted. The cost of misoprosl is one hundredth cheaper than dinoprostone. There was no significant differences in the fetal outcome and maternal outcome. CONCLUSION: These results suggest that intravaginal misoprostol(PGE1) is a safe drug for labor induction which is more effective and cheaper compare to intravaginal dinoprostone(PGE2).
Alprostadil* ; Cesarean Section ; Dinoprostone* ; Female ; Heart Rate, Fetal ; Humans ; Labor Pain ; Meconium ; Misoprostol* ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Prospective Studies ; Rupture

Sebaceous carcinoma of the eyelid is a rare tumor that usually arises from tarsal sebaceous gland. Because the clinical manifestations can masquerade as unilateral recurrent chalasion or chronic blepharoconjunctivitis, its diagnosis may be delayed. Therefore, early biopsy for diagnosis is needed for the persistently recurring unilateral blepharoconjunctivitis. The masquerade syndrome was first described in 1967 by Theodore and Irvine as chronic blepharoconjunctivitis due to an underlying conjunctival carcinoma. While the originally described neoplasms were squamous cell carcinomas, many of the tumors producing this clinical picture are believed to be sebaceous in origin. We experienced a case of pathologically confirmed sebaceous carcinoma of the eyelid which originally masqueraded as chronic blepharoconjunctivitis and was treated with topical antibiotics and steroids for 1 year and 8 months, finally being treated by partial orbital exenteration.
Anti-Bacterial Agents ; Biopsy ; Carcinoma, Squamous Cell ; Conjunctivitis* ; Diagnosis ; Eyelids ; Orbit ; Sebaceous Glands ; Steroids

In an attempt to investigate which of the ST-segment parameters, e.g., ST-segment level, ST-segment slope, ST-segment index and ST-segment intergral obtained by mannual drawing can most sensitively indicate quantitatively the extent of exertional myocardial ischemia in patients with angina pectoris, 26 patients with angina pectoris underwent exrecise stress testing, using a bicycle ergometer and thallium-201 myocardial perfusion scintigraphy(Thallium-201 MPS). The exrecise was terminated either when symptoms or signs indicative of myocardial ischemia developed or when the heart rate reached the predicted maximal heart rate during exrecise. The myocardial ischemia region was quantitated by Thallium-201 MPS. The number of myocardial ischemia segments was similar in patients who had positive exrecise test(4.9+/-1.9) and in those who had negative result(3.7+/-2.2). However, it was greater in patients who showed pseudonormalization of the T wave in exercise ECG(6.3+/-2.6) than in those with negative exercise test(3.7+/-2.2)(P<0.05). The extent of myocardial ischemia region expressed by the number of myocardial ischemia segments correlates best with the ST-segment index(r=-0.83) among ST-segment slop(r=-0.60), ST-segment intergral(r=-0.59) and ST-segment(r=0.50). These data suggest that the ST-segment index is the most reliable indicator to reveal the extent of exertional myocardial ischemia among the ST-segment parameters and that pseudonormalization of T wave in exercise ECG is a finding indicative of exertional myocaridial ischemia in patients with angina pectoris.
Angina Pectoris ; Electrocardiography* ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia* ; Perfusion

No abstract available.
Giant Lymph Node Hyperplasia* ; Neck*

Giant cell tumor of the spine is a rare and potentially malignant condition which presents rather difficult clinical problems in treatment because of their localization and unpredictable clinical course. Authors experienced a case of giant cell tumor involving third lumbar vertebra which was successfully treated by ea bloc resection and anterior interbody fusion of the adjoining vertebrae with iliac bone graft. At eighteen months follow up, there is no evidence of recurrence and solid union of the bone graft was noted.
Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Recurrence ; Spine ; Transplants

Among 334 thoracolumbar spinal injury patients who were admitted to this hospital from June 1972 to June, 1982, 66 patients with fracture and fracture dislocation of thoraco-lumbar spine which were defined as unstable clinically and radiologically were treated with surgical measures. The ratio between male and female was 7.3:1, the majority was found in third and fourth decade (46 cases, 69%), and the most common cause of injury was falling from a height (38 cases, 58%). The most common site of the injury was lumbar spine (29 cases, 44%) and the most common mechanism of injury was flexion-rotation (29 cases, 44%). Our surgical measures were Harrington rod instrumentation with either anterior or posterior fusion (25 cases, 38%), posterior wiring and fusion (14 cases, 21%), anterior decompression and anterior fusion (14 cases, 21%), posterior fusion (4 cases, 6%), anterior fusion and posterior fusion (3 cases, 5%) and etc. The average correction of displacement was 65% and the average correction of kyphotic deformity was 50%. The most remarkable correction was found at the cases of Harrington rod instrumentation (71%, 74%). Neurological deficit had already developed in 43 cases(65%) prior to operation, and the recovery was observed in 18 cases(42%). Most excellent recovery of neural deficit was found also at the cases of Harrington rod instrumentation (11 cases, 52%). We have analysed the results of these treatment and obtained following conclusions. 1. For the unstable fracture and fracture-dislocation of thoraco-lumbar spine with or without neural involvement, immediate surgical treatments were valuable to expect restoration of anatomical reduction and promotion of every possible recovery of neural function with spinal stability and fewest complication. 2. Fixation with Harrington rod instrumentation appears to provide better reduction and stability with neural improvement than other methods, and therefore early undertaking of rehabilitation activities is possible. 3. For the patients who are seriously compromised or require anterior decompression, immediate posterior reduction and fixation with Harrington rod instrumentation followed anterior decompression and anterior fusion of the involved segments at the eariest feasible time, we feel, is the treatment of choice.
Accidental Falls ; Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Female ; Humans ; Male ; Mortuary Practice ; Rehabilitation ; Spinal Injuries ; Spine

There was increasing tendency to stabilize unstable cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and therefore early rehabilitation. A clinical study was performed on 47 patients with fractures and dislocations of the cervical spine treated at the department of orthopedic surgery, Inje Medical College, Paik Hospital from Jan. 1975 to Dec. 1981. Following is the summery of the our findings. 1. The prevalent age distribution was between 3rd and 6th decade and the ratio between males and females was 10:1. The most common cause of injuries was automobile accident (70%). 2. The most common site of the injuries was C5-6 (34%) and the most frequent mechanism of injury was flexion-rotation type (47%). 3. In overall patients, neurologic damage was found at first examination in 73% and among these, complete paralysis below the injured level in 26%, incomplete paralysis in 11% and nerve root injury in 35%. 4. Among 47 patients, conervative treatment was performed on 9 patients, anterior spinal fusion on 8 patients, anterior spinal fusion with Halo application on 4 patients, posterior wiring with posterior spinal fusion on 16 patients and posterior wiring with anterior spinal fusion on 8 patients. 5. In the several methods of treatment, the posterior wiring with anterior spinal fusion revealed the best results, the correction rate of displacement was 92%, the correction rate of angular deformity 98% and neural recovery rate 72%. 6. The posterior wiring with posterior spinal fusion revealed good results in correction of displacement and angular deformity but required rigid external support for a long time. The anterior spinal fusion revealed poor results in correction of displacement(67%) and angular deformity(38%) and required rigid external support for a long time and had increasing tendency of kyphotic angle after operation. 7. In the treatment of unstable cervical spine injury, we thoughy that early posterior reduction with posterior wiring and followed anterior spinal fusion was ideal for accurate reduction, rigid stability and early mobilization with simple external support.
Age Distribution ; Automobiles ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Early Ambulation ; Female ; Humans ; Male ; Nursing Care ; Orthopedics ; Paralysis ; Rehabilitation ; Spinal Fusion ; Spine