No abstract available.
Poliomyelitis*

The purpose of our study is to evaluate the visual, refractive and IOP results following combined small incision phacoemulsification, foldable lens implantation, and fornix based trabeculectomy with Mitomycin-C. Seventy-six eyes of 64 patients with cataract and glaucoma had undergone the combined procedure. Minimal follow-up period was 6 months(mean 12.8+/-4.8 months). All the eyes that were free of preexisting macular disease and endstage glaucomatous optic nerve damage demonstated significant improvement in visual acuity. Postoperative astigmatisn was negligible(-0.41diopters). The average IOP reduction was 7.7mmHg. Functioning filtrating bleb persisted in 76.3% of the eyes. Complications with this method were not significant compared with other studies reporting the combined procedure. The small incison phacotrabeculectomy with mitomycin-C technique that we describe appears to be effective in early restoration of visual acuity and reduction of IOP without significant complications.
Blister ; Cataract ; Follow-Up Studies ; Glaucoma ; Humans ; Mitomycin* ; Optic Nerve ; Phacoemulsification* ; Trabeculectomy* ; Visual Acuity

No abstract available.

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type 1and 2 DM are most common form and the prevalence of the latter is recently increasing. The aim of this article was to assess whether Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction was larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 DM itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered. The function of polymorphonuclear leukocyte is also impaired and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process. Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.
Animals ; Blood Glucose ; Blood Vessels ; Collateral Circulation ; Dentists ; Diabetes Mellitus ; Humans ; Inflammation ; Insulin ; Microcirculation ; Neutrophils ; Prevalence ; Rats ; Regeneration ; Risk Factors ; United Nations

No abstract available.
Hepatitis, Autoimmune* ; Polyneuropathies*

PURPOSE: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. MATERIALS AND METHODS: We performed perfusion MR imaging preoperatively in the consecutive 15 patients with intracranial masses (3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurcyotma, 1 metastasis, 2 abscesses, 1 radionecrosis ). The averages age of the patients was 42 years (22yr-68yr), composed of 10 males and 5 females. All MR images were obtained at 1.5T imager(Signa, GE Medical systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media.(contrast media: 15cc of gadopentate dimeglumine, about 2ml/sec by hand, staring at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(GE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE 50ms, flip angle 90degree, FOV 240x240, matrix 128x128, slice-thick/gap 5/2.5). After data collection, the raw data were transferred to GE workstation and rCBV maps were generated from the numerical integration of deltaR2* on a voxel by voxel basis, with home made software(deltaR2*=-ln(S/S0/TE). For easy visual interpretation, relative RGB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Gd-enhanced images with focus on the degree and extent of perfusin and contrast enhancement. RESULTS: Two cases of glioblastoma multiforme with rim enhancement on Gd-enhanced T1 weighed image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin, In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. CONCLUSION: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade glioma. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.
Abscess ; Blood Volume ; Brain Abscess ; Brain Neoplasms* ; Brain* ; Clinical Coding ; Data Collection ; Discrimination (Psychology) ; Female ; Germinoma ; Glioblastoma ; Glioma ; Hand ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Meningioma ; Necrosis ; Neoplasm Metastasis ; Neurocytoma ; Perfusion* ; Retrospective Studies

PURPOSE: It is known that due to both their imaging and pathologic features, the accurate differentiation ofchondrosarcoma from chordoma is difficult. Through an analysis of MR and CT findings, this study aims to determinethe differential points between these two tumors. MATERIALS AND METHODS: In 21 patients, CT and MR imagingstudies of chordoma(n=12) and chondrosarcoma(n=9) at the base of the skull were retrospectively reviewed.Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomaswere subclassified as 'conventional' and one as 'chondroid'; eight chondrosarcoma were 'conventional' andone was 'myxoid'. Four chordoma patients underwent CT and MR ; in six, only MR was performed ; and in two, onlyCT. Eight chondrosarcoma patients underwent both CT and MR, while in one, only CT was performed. All scans wereretrospectively evaluated for the location(midline/off-midline), direction of extension, margin and shape, bonydestruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcificationwas graded from I to III. RESULTS: The epicenter of the mass of ten chordomas (83%) was midline, in twochondrosarcomas(22%), this was off-midline. Foci of calcification were observed in three of eleven chordomas(27%),and heavy calcification (grade III) was observed in one. In contrast to these findings, foci of calcificationswere observed in eight of nine chondrosarcomas (89%) and grade III calcification was observed in five. In bothtumors, calcification was coarse. Between the two kinds of tumor, there were no significant difference in MRsignal intensity and enhancement patterns, margin and shape, or direction of extension. CONCLUSIONS: Although MRand CT findings were similar in both types of tumor, location and degree of calcification may be features whichusefully distinguish chordoma from chondrosarcoma.
Chondrosarcoma* ; Chordoma* ; Humans ; Retrospective Studies ; Skull Base* ; Skull*

In 24 healthy adult patients having orthopedic surgical procedures requiring the use of a tourniquet under general anesthesia with controlled mechanieal ventilation, we have deter- mined ehanges in end tidal CO2(PetCO2) and arterial blood gas values before and after release of tourniquet. After deflation of tourniguet, PETCO and PaCO2 increased significantly with the maximal elevation occuring within two minutes. The pH level decreased significantly and maximally within three minutes. There was statistically significant linear correlation between PCO and PaCO2 Sugesting prediction of the PaCO2, level by monitoring the PetCO2 level. On these findings, hyperventilation may be indicated to facilitate the return of PaCO2 and pH to baseline just before and for several minutes after tourniquet release, especially in patients with increased intracranial pressure. In conclusion, we recommend noninvasive monitoring of the PetCO2 level instead of invasive measure-ment of the PaCO2 level.
Adult ; Anesthesia, General ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Intracranial Pressure ; Orthopedic Procedures ; Tourniquets* ; Ventilation

BACKGROUND: Intravascular ultrasound(IVUS) provides high resolution cross-sectional images of the vessels and permits the quantiative and qualitative assessment of coronary artery disease. Stent is a figid endovascular lattice that effectively prevents elastic recoil at treated sites, but in-stent restenois is a major limitation. The purpose of thecurrent study is to assess the contribution of neointimal hyperplasia for in-stent restenosis and the distribution and morphological characteristics of neointimal hyperplasia in deployed stents. METHODS: Thirty patients(male 25 & female 5;31 leions) deployed with intracoronary stents underwent intravascular ultrasound imaging at follow-up at least 4 months after stenting ([mean+/-SD] 8.3+/-2.9 months). RESULTS: 1) In-stent restenosis occurered in 15 lesions out of 31 lesions at follow-up coronary angiography. There was no difference in clinical characteristics between the restenotic and the non-restenotic groups. 2) There was no difference in angiographic profiles between two groups. Deployed stents were as follows ; 16 Palmaz-Schatz(P-S) stents, 12 Gianturco-Roubin(G-R) stents, 2 Cordis stents, and I Microstent II. Average diameter of stents in the restenotic and the non-restenotic groups were 3.07+/-0.26mm and 3.16+/-0.30mm, respectively(p=0.38). 3) There was no difference of stent cross-sectional areas(CSA) between the non-restenotic and the restenotic groups(p=0.476), but luminal CSA of the restenotic group was significantly smaller than that of the non-restenotic group(p=0.006). 4) In the restenotic group, there were no differences of the maximal and the minimal diameters of stents, and the mean CSAs of stents smong proxiaml, mid and distal segments. But the mean CSA of neointimal hyperplasia at the mid segment was larger than that at the distal segment(p<0.05). There was a tendency thatthe mean CSA of neointimal hyperplasia at the mid segment was larger than that at the proximal segment(p=0.187). These findings were the same in the non-restenotic group. 5) In the restenotic group deployed with P-S stents, there were no differences of the maximal and the minimal diameters of stents, and the mean cross-sectional areas(CSA) of stents between each segment. But, the mean CSA of neointimal hyperplasia at the mid segment was larger than that at the distal segment(p<0.005) and there was a tendency that the mean CSA of neointimal hyperplasia at the mid segment was larger than that at the proximal segment(p=0.354). 6) In the morphology of neointimal hyperplasia of the restenotic group, eccentric form(77%) was more common than concentric form(22%). Neointimal hyperplasia occurred in focal or diffuse patterns(7 versus 8 cases). CONCLUSIONS: In-stent restenosis resulted from neointimal hyperplasia which almost mainly occurred eccentrically at the mid segment of stents and in focal or diffuse patterns. Intravascular ultrasound imaging was a useful method for recognition of distribution and morphological characteristics of neointimal hyperplasia at follow-up of deployed stents.
Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Follow-Up Studies ; Humans ; Hyperplasia* ; Phenobarbital ; Stents* ; Ultrasonography*

Lipoblastoma are rare benign tumors arising from the fetal-embryonal fat that occur almost exclusively in children. About 70% of them arise in the limbs but several other sites have been reported. We have treated a 3-year-old boy who had a benign lipoblastoma in left posterior mediastinum and left supraclavicular area. CT scanning demonstrated a mass of principally fat attenuation which had a compressive effect on normal intrathoracic structures. The tumor was resected completely without complication from the left posterior mediastinum and left supraclavicular area. The tumor mass was yellowish in color and it was histopathologically confirmed to be a lipoblastoma.
Child ; Child, Preschool ; Extremities ; Humans ; Lipoblastoma* ; Male ; Mediastinum* ; Neck* ; Tomography, X-Ray Computed