PURPOSE: We evaluated the risk factors and related results of residual diplopia and enophthalmos in patients who had orbital wall fracture repair. METHODS: 50 patients with orbital wall fracture who were followed up for at least 6 months postoperatively were included in this study. We analyzed effects of the patient age, timing of surgery, size and location of fracture on development of postoperative diplopia and enophthalmos. RESULTS: 32 patients had diplopia and 16 patients had enophthalmos greater than 2 mm. Among 32 patients with preoperative diplopia, 9 patients experienced postoperative diplopia. Among 16 patients with preoperative enophthalmos, 5 patients experienced postoperative enophthalmos. Delayed timing of surgery was a significant factor for development of postoperative diplopia and enophthalmos. Age of the patients and fracture size were not significant factors for development of postoperative diplopia and enophthalmos. CONCLUSIONS: Early surgical repair of orbital wall fractures decreases the incidence of residual diplopia and enophthalmos. Preoperative assessment of multiple variables could help to achieve cosmetical and functional better results.
Diplopia* ; Enophthalmos* ; Humans ; Incidence ; Orbit* ; Risk Factors

PURPOSE: To evaluate the efficacy of vitrectomy in patients with diabetic macular edema. METHODS: The results of pars plana vitrectomy in 10 eyes were analyzed. Major outcome measurements were preoperative and postoperative best corrected visual acuity, fundus findings of macula, and postoperative complications. All eyes had at least 4 months of follow- up after surgery. RESULTS: The improvement of visual acuity up to 2 lines on the chart was found in 5 eyes (50%) after the surgery and six eyes (60%) showed improvement in macular edema. The complications after surgery were vitreous hemorrhage in 1 eye and submacular exuadates in 1 eye. CONCLUSIONS: Vitrectomy may be beneficial for patients with diabetic macular edema.
Humans ; Macular Edema* ; Postoperative Complications ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Compound nerve action potential (CNAP) of the mixed peripheral nerve is composed of A alpha beta, A delta, and C potentials. All components of CNAPs in the sciatic nerve were recorded by stimulating the tibial nerve of both control and lead-poisoned rats. Marked decrease of nerve conduction velocity and prolonged duration were found in A alpha beta and A delta fibers especially in large myelinated A alpha beta fibers. The amplitude decreased in A alpha beta potential, but the area did not change. In C potential produced by activation of unmyelinated fibers, nerve conduction velocity slightly decreased, but the amplitude and area did not significantly change. Pathologic correlates revealed prominent segmental demyelination with significant decrease of large myelinated fiber densities. Minimal axonal degeneration of unmyelinated fibers was present. We can conclude that electrophysiologic changes in the lead-poisoned rats correlate with pathologic changes in them.
Animals ; Electrochemistry ; Lead Poisoning/complications/*pathology ; Neural Conduction ; Peripheral Nervous System Diseases/chemically induced/*pathology ; Rats ; Rats, Inbred Strains ; Sciatic Nerve/pathology

Coronary artery steonosis can be effectively treated by non-operative percutaneous tansluminal coronaryangioplasty(PTCA). We performed PTCA in three patients with coronary artery stenosis, who were referred to thedepartment of radiology, from January to Dec. in 1985. The results were as follows; 1. The locations of coronaryartery stenosis were the proximal anterior descending branch of left coronary artery. 2. The number of stenoticlesions was single without calcium plaque in all three cases. 3. The extent of coronary artery disease is focal,under 2cm in length. 4. PTCA was performed successfully with satisfactory post-dilatation results in all cases. 5.Severe complications such as arterial intimal dissection, acute myocardial infarction, did not occurred. PTCA hasmany advantages over vascular surgery on surgical, economical, and psychological aspects.
Angioplasty, Balloon, Coronary ; Calcium ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Myocardial Infarction

OBJECTIVE: It was to analyze two failed arterial embolization cases in the treatment for pseudoaneurysm followed by D&C. METHODS: Two failure cases out of eight cases were gained in the transarterial embolization treatment for eight years.(1. 1. 1992 - 12. 31. 1999) To search for the factors of failure, we went through obstetrical history and biopsy. RESULTS: Eight cases of transarterial embolization were performed to the treatment for pseudoaneurysm appeared after undergoing D&C. Six cases were successfully treated without complications. However, laparotomy was done due to the continuous bleeding in the other two cases. According to tissue biopsy, they showed the cervical pregnancy in one case and placenta accreta in the other. CONCLUSION: Transarterial embolization is proved to be more preferable to operate in the treatment of pseudoaneurysm than laparotomy, and transarterial embolization therapy failure rate is higher in case of existing remnant villi than not.
Aneurysm, False* ; Biopsy ; Dilatation and Curettage* ; Female ; Hemorrhage ; Hysterectomy ; Laparotomy ; Placenta Accreta ; Pregnancy

PURPOSE: There are many cases of paroxysmal supraventricular tachycardia (PSVT) presenting to the emergency department (ED) with palpitation as the presenting symptom. Adenosine is usually administered for conversion to normal sinus rhythm, with a possible second dose in the case of no response. As adenosine has a short acting time, administration of the drug at a vessel as close to the heart as possible is recommended, followed by an extra normal saline bolus infusion. In this study, we hypothesized a better outcome when adenosine was administered after proper injection method instruction was given to the medical staff. METHODS: We retrospectively studied the population of PSVT patients treated with adenosine. The cases were divided into two groups: one group consisted of cases a year before instruction for adenosine use became routine practice, and the second was comprised of cases a year after instruction protocols had been put into place. We further analyzed the proportion of patients who converted to normal sinus rhythm after a single dose of adenosine. RESULTS: All 306 patients were included. Before instruction, 46 patients (40.0% of 115) converted to normal sinus rhythm after the first dose. After instruction, 108 patients (56.5% of 191) converted to normal sinus rhythm after the first dose, which was statistically significant (p<0.05). CONCLUSION: After receiving proper education, more patients converted to normal sinus rhythm after the first dose. Instruction for proper adenosine injection technique for PSVT cases can increase the success rate of rhythm conversion on the first attempt.
Adenosine* ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Heart ; Humans ; Medical Staff ; Retrospective Studies ; Tachycardia, Supraventricular*

BACKGROUND: TNF-alpha is related to the generation of lung fibrosis in patients with UIP. The precise mechanism leading to lung fibrosis by TNF-alpha is unknown. However, the activation of a transcription factor like AP-1(down stream of c-jun N-terminal kinase, JNK) by TNF-alpha may be related to the induction of fibrogenic cytokines like PDGF or IGF-I. Furthermore, JNK was reported to be activated in the radiation-in-duced lung fibrosis model. This study examined JNK activity in patients with UIP. METHODS: The expression of phosphorous JNK(p-JNK), macrophage/moncoyte specific markers, CD68, and cytokeratin was evaluated by immunohistochemical (IHC) staining of lung tissues from patients with UIP and lung cancer. An in vitro kinase assay was performed with alveolar macrophages obtained by a bronchollung cancer. An in vitro kinase assay was performed with alvolar macrophages obrtained by a bronchol avleolar lavage from patients with UIP and healthy persons as the control. RESULTS: The IHC stain showed that p-JNK is expressed in the almost all of the alveolar macrophages and smooth muscle cells in patients with UIP. In case of the normal areas of the lung from patients with lung cancer, the alveolar macrophages showed little p-JNK expression. Interestingly, increased JNK activity was not found in the in vitro kinase assay of the alveolar macrophages obtained from both patients with UIP and healthy persons as the control. Furthermore, 10 ng/ml of TNF-alpha failed to increase the JNK activity of the alveolar macrophages in both patients with UIP and healthy people. CONCLUSION: The JNK was activated constitutionally in patients with UIP. However, the role of JNK in the pathogenesis of lung fibrosis needs to be clarified.
Constitution and Bylaws ; Cytokines ; Fibrosis ; Humans ; Insulin-Like Growth Factor I ; JNK Mitogen-Activated Protein Kinases* ; Keratins ; Lung ; Lung Neoplasms ; Macrophages ; Macrophages, Alveolar ; Myocytes, Smooth Muscle ; Phosphotransferases ; Rivers ; Therapeutic Irrigation ; Transcription Factors ; Tumor Necrosis Factor-alpha

PURPOSE: To determine the clinical efficacy of percutaneous vertebroplasty in cases of painful and medically intractable osteoporotic vertebral compression fracture. MATERIALS AND METHODS: Ninety-eight patients (20 men and 78 women; mean age, 69 years) underwent 122 per-cutaneous vertebroplasty procedures for the treatment of osteoporotic vertical compression fracture. For the evaluation of bone mass, bone densitometry was performed in 45 patients, and to assess the recent evolution of the fracture, all 98 underwent MRI. Percutaneous vertebroplasty involves percutaneous transpedicular puncture of the involved vertebrae followed by the injection of a Polymethylmethacrylate(PMMA)-Barium mixture into the vertebral body. To assess leakage of the mixture into the epidural tissue, neural foramina, venous plexus and paravertebral tissue, we then immediately obtained a computerized tomographic (CT) scan, assessing the clinical efficacy of the procedure on the basis of time required for pain relief (defined as more than 60% reduction of initial pain), and time required for ambulation without significant pain. RESULTS: Percutaneous vertebroplasty was successful in all patients. Pain relief was accomplished within 1-5(mean, 1.8) days and early ambulation without significant pain was possible within 2 -15 (mean, 3.3) days. Post-procedural CT scanning revealed leakage of the PMMA-barium mixture into Paravertebral tissue(n=41), the paravertebral venous plexus (n=34) and epidural tissue (n=4). No neural foraminal leakage was identified, and no procedure-related complication requiring surgical treatment occurred. CONCLUSION: Percutaneous vertebroplasty is an effective new interventional procedure for the treatment of osteoporotic vertebral compression fracture. It relieves pain, provides early mobilization, and strengthens involved vertebral bodies.
Densitometry ; Early Ambulation ; Female ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging ; Male ; Osteoporosis ; Punctures ; Spine ; Tomography, X-Ray Computed ; Vertebroplasty* ; Walking

Wiskott-Aldrich syndrome(WAS) is an X-linked recessive immunodeficiency characterized by thrombocytopenia with small platelet volume, eczema, and recurrent infections, and is also characterized by increased incidence of auto immune diseases and malignancies. The phenotype observed in this syndrome is caused by mutation in the Wiskott-Aldrich syndrome protein(WASP) gene localized to the proximal short arm of the X chromosome and recently isolated through positional cloning. The gene encodes a 502 amino acid protein, which contains 12 exons and spans 9 kb of genomic DNA. The function of the encoded protein is not well understood. The clinical diagnosis of WAS can be difficult and is usually confirmed by the detection of WASP gene mutations and the expression of WSAP in patient blood sample using genetic analysis. We reported a case of a 13-month old boy with WAS who was identified with the novel mutation in exon 2 of WASP gene by direct sequencing and the complete absence of WASP expression by immunoblotting.
Arm ; Blood Platelets ; Clone Cells ; Cloning, Organism ; Diagnosis ; DNA ; Eczema ; Exons* ; Humans ; Immune System Diseases ; Immunoblotting ; Incidence ; Infant ; Male ; Phenotype ; Thrombocytopenia ; Wasps* ; Wiskott-Aldrich Syndrome* ; X Chromosome

PURPOSE: We conducted the immunoassay of pertussis according to ages, in order to evaluate protective immunity against pertussis in Korean populations. METHODS: Healthy subjects were enrolled at four university hospitals in Korea. The subjects were grouped as seven age groups (every 10 years). Antibodies against pertussis toxin (PT) in sera were measured by enzyme linked immunosorbent assay (ELISA) kits. Geometric mean concentrations (GMC) of antibodies and the ratios of the subjects with seroprotective antibody levels were determined. The subjects with antibody titers > or =24.0 EU/mL were considered to seroprotective as the manufacturer's protocol. RESULTS: Total 1,605 subjects (age: 2 months-65 years) participated in this study, and their GMC was 56.16+/-50.54 EU/mL. Among seven age groups, age group <11 year showed the highest GMC (64.78+/-53.24 EU/mL) (P<0.001). In the analysis of the ratios of the subjects with seroprotective antibody titers, 68.2% of the subjects were proven to seroprotective, and age group <11 year also showed the highest ratio (76.5%) (P<0.001). CONCLUSIONS: We found that adolescences or adults (age group > or =11 year) showed lower levels of antibody against pertussis and lower ratio of the subjects with seroprotective antibody titers than children (age group <11 year).
Adult ; Antibodies ; Child ; Enzyme-Linked Immunosorbent Assay ; Hospitals, University ; Humans ; Immunization ; Immunoassay ; Korea ; Pertussis Toxin ; Whooping Cough