The authors experienced corneal blood staining after traumatic hyphema with primary open angle glaucoma and studied corneal blood staining by electron microscope. The electron microscpic finding were as follows: 1. The destructive RBC particles were found in entire cornea except deep stroma by light microscope. 2. The destruction of endothelium and intact Descemet's membrane were found and few RBC particles in the keratocyte and interlamellar space were observed by electron microscope. 3. Amorphous granules in the superficial stroma were darker than the ones in the deep stroma by electron microscope. 4. The granules were observed between basal cell layer and wing cell layer in epithelium. We suggest that clearing mechanism of corneal blood staining are scavening action of phagocytic cells and migration from deep layer to superficial layer of granules.
Blood Stains* ; Cornea ; Descemet Membrane ; Endothelium ; Epithelium ; Glaucoma, Open-Angle ; Hyphema* ; Phagocytes

The effects of several anesthetios (thiopental, ketamine, Innoyar) and muscle relaxants (succinylcholine and vecuronium) on IOP, blood pressures and pulse rates were studied in 60 Patients ranging in are 12 to 56 years. IOP was measured with the Schiotz tonometer. In addition to tonometric determinations, the blood pressures and pulse rates were recorded. The patients were divided into 4 groups: Thiopental-succinylcholine-intubation(Group 1) ; Ketamine-succinrlcholine-intubation (Group 2) ; Innovar-succitrlcholine-intubation (Group 3) and Thiopental-vecuronium-intubation (Group 4) . The results were as follows : 1) In group 1 and 4, IOP changes following thiopental(5 mg/kg) administration showed highly significant decreases(p<0.01) after 1 minute compared with the control value. 2) In group 1 and 3, IOP changes after 1 minute following succinrlcholine administration showed mild increases and were not statistically significant(p>0.05) and in group 2, IOP changes after 5 minute following succinylcholine administration shewed highly significant increases (p<0.01) . 3) In group 3, IOP changes after 5 minutes following Innovar (1 ml/15 kg) administration showed highly significant decreases (p<0.01) compared with the control value. 4) IOP changes after 1 minute of endotracheal intubation showed highly significant inc- reases (p<0.01) in all groups compared with the control value. 7) In group 4, IOP changes following vecuronium administration instead of succinylcholine showed highly significant decreases, but could not prevent the increases in IOP following endotracheal intubation. 6) In all groups, blood pressures and pulse rates showed highly significant increases after endotracheal intubation. 7) After succinylcholine administration, blood pressures showed aignificant increases in group 1 and highly significant increases in group 2. 8) In group 2, blood pressures showed highly significant increases after ketamine administration.
Anesthetics* ; Blood Group Antigens ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation, Intratracheal ; Ketamine ; Succinylcholine ; Vecuronium Bromide

The effects of general anesthesia on intraocular pressure were studied in 30 patients ranging in age from 15 to 48 years old. The intraocular pressure was measured by the Schiotz tonometer. The patients were divided into 2 groups: thiopental-succinylcholine-intubation (Group 1) and thiopental-vecuronium-intubation(Group 2). The results were as follows: 1) IOPs after thiopental(5 mg/kg) administration were decreased significantly compared with the control value in both group(p<0.05). 2) IOP after succinylcholine administration were elevated, but it was not statistically significant compared with the control value. 3) IOP after vecuronium administration was decreased significantly compared with the control value(p<0.05). 4) IOP after intubation were elevated significantly compared with control value in both groups(p<0.05). 5) IOP at 10 minutes after the induction of general anesthesia was not changed compared with the control value in group 1, but was decreased significantly in group 2(p<0.05).
Anesthesia, General* ; Humans ; Intraocular Pressure ; Intubation ; Middle Aged ; Succinylcholine ; Vecuronium Bromide

No abstract available.
Aged* ; Humans

The incidence of metastasis to the eye and its related structure on recent studies appear to be more common than previous studies demonstrate. The authors experienced a case of hepatocellular carcinoma metastatic to the conjunctiva. A 48-year-old man with known hepatocellular carcinoma in the liver had a mass surrounded with blood clot on the upper palpebral conjunctiva of right eye. A biopsy demonstrated that the lesion was hepatocellular carcinoma metastatic to the conjunctiva.
Biopsy ; Carcinoma, Hepatocellular ; Conjunctiva ; Humans ; Incidence ; Liver ; Middle Aged ; Neoplasm Metastasis

OBJECTIVE: The purpose of this study is to review retrospectively 28 patients with re-operation due to complications related to instrumentation from thoracic and lumbar spinal fusion surgery. METHODS: A total of 285 patients underwent spinal fusion surgery with instrumentation between 1996 and 2000. Of these, 11 men and 17 women(mean age 46 years, range 21 to 69 years) presented with complications related to instrumentation. Previous surgery was preformed for vertebral column instability secondary to fracture(4), spondylolisthesis(12), failed back surgery syndrome(7), osteomyelitis(1), herniated nuclus pulposus(4). All patients underwent repeated spinal surgery including removal of instrument, new instrument fixation, or I & D. The mean follow-up period after second operation was 19 months. RESULTS: The complications related instrumentation system include six interbody fusion system retropulsion, eight screw loosenings, five screw fractures, three screw malpositions, three osteomyelitis, and one donor site infection. After repeated surgery, eight became asymptomatic and did not require further treatment, but eleven showed persistent low back pain without neurological deficits and the remaining nine continued to have nerve root deficits. CONCLUSION: In conclusion, spinal fusion surgery with instrumentation offers an immediate postoperative stability of the thoracic and lumbar spine and enhances early fusion. However, it may be associated with few, but significant, complications which may permanantly. The proper selection of patients and meticulous surgical technique for surgery are probably the most important factors associated good outcomes and prevention of complications.
Follow-Up Studies ; Humans ; Low Back Pain ; Male ; Osteomyelitis ; Retrospective Studies ; Spinal Fusion* ; Spine ; Spondylolisthesis ; Tissue Donors

BACKGROUND AND OBJECTIVES: Mechanisms of restenosis following successful coronary angioplasty (PTCA) are knownasvascularsmoothmuscle cells(VSMCs)proliferationandmigration, elastic recoil or vascular wall remodeling. Paclitaxel whose effect on the stabilization of microtubles leads to cell death is highly lipophilic, permitting easy pass through cell membrane, and has a long-term antiproliferative effect. This study was performed to evaluate effect of paclitaxel on VSMCs proliferation and whether locally delivered paclitaxel can prevent stenosis and neointimal formation in rat carotid artery injury model. MATERIALS AND METHODS: Cultured VSMCs were exposed to sequential concentrations of paclitaxel in vitro, and proliferation inhibition was analyzed with 3H-thymidine incorporation. Paclitaxel of a suitable concentration was applied to the endothelium-denuded carotid artery of Fisher 344 inbred rats for 20 minutes. Angiogram and morphometric analysis of carotid artery was performed after 2 weeks. RESULTS: 3H-thymidine incorporation in cultured VSMCs was decreased dose-dependently from the concentration of 0.1 micromol/L (2,454+/-149cpm/ microgram protein) to 100 micromol/L (1,323+/-69cpm/ microgram protein) of paclitaxel by single and 20-minute exposure in the presence of platelet-derived growth factor (p<0.005). In the absence of platelet-derived growth factor, the decrement of 3H-thymidine incorporation was evident above the concentration of 5 micromol/L of paclitaxel. To evaluate in vivo effect, paclitaxel (0.1 or 1 micromol/L) was administered into the endothelium-denuded carotid artery by balloon injury and incubated for 20 minutes. Percent stenoses (32.2+/-9.8%) of paclitaxel-treated group was less than those (46.3+/-7.5%) of control group on histologic analysis (p<0.01). Paclitaxel-treated group also had wider lumen on carotid angiogram and less neointimal thickening than control on histologic examination (p<0.005). CONCLUSION: Proliferation of VSMCs was effectively inhibited and neointimal formation and luminal stenosis was prevented in rat carotid artery injury model by single, brief and local delivery of low-dose paclitaxel. This strategy could be applied to clinical settings for the prevention of restenosis after PTCA.
Angioplasty ; Animals ; Carotid Arteries* ; Carotid Artery Injuries ; Cell Death ; Cell Membrane ; Constriction, Pathologic ; Neointima ; Paclitaxel* ; Phenobarbital ; Platelet-Derived Growth Factor ; Rats*

For the physical characterization of neutron beam, dosimetric measurements had been performed to obtain physical data of KCCH cyclotron-produced neutrons for clinical use. The results are presented and compared with the data of other institutions from the literatures. The central aixs percent depth dose, build-up curves and open and wedge isodose curve values are intermediate between that of a 4 and 6 MV X-ray. The build-up level of maximum dose was at 1.35 cm and entrance dose was approximately 40%. Flatness of the beam was 9% at Dmax and less than+/-3% at the depth of 80% isodose line. Penumbra begond the 20% line is wider than corresponding photon beam. The output factors ranged 0.894 for 6 x 6 cm field to 1.187 for 30 x 30 cm field. gamma contamination of neutron beam was 4.9% at 2 cm depth in 10 x10 cm field.
Cyclotrons ; Neutrons*

OBJECTIVE: The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. METHODS: We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. RESULTS: The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. CONCLUSION: We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.
Cadaver* ; Decompression ; Female ; Humans ; Intraoperative Complications ; Male ; Spinal Nerves ; Spine*

We report here on our technique and outcomes of the first two cases of robot-assisted laparoscopic nephroureterectomy with a bladder cuff excision(RLNU). RLNU was performed on two female patients who both had a muscle invasive lower ureter tumor. For the first step, nephroureterectomy was performed in the lateral flank position. For the second step, bladder cuff excision and bladder repair were performed in a steep Trendelenburg position. The specimen was extracted through a 6 cm sized incision in the umbilical trocar site. Both procedures were successfully completed with using the robot without conversion to open surgery. The total operative time, including the lymphadenectomy and the robot docking times, was 320 and 241 minutes, respectively, for the 2 patients. The estimated blood loss was 40 and 200 ml, respectively. The pathological examinations showed stage T3 and T2 invasive transitional cell carcinoma of the ureter. The patients' postoperative recoveries were uneventful and the bladder cuff was free of tumor. RLNU may have potential advantages over open and laparosopic surgery due to its minimal invasiveness. This approach can be an alternative to open surgery or laparoscopic technique.
Carcinoma, Transitional Cell ; Conversion to Open Surgery ; Female ; Head-Down Tilt ; Humans ; Laparoscopy ; Lymph Node Excision ; Muscles ; Operative Time ; Resin Cements ; Robotics ; Surgical Instruments ; Ureter ; Ureteral Neoplasms ; Urinary Bladder