In order to evaluate the ocular autonomic dysfunction in diabetics, pupil cycle time(PCT) was assessed in 201diabetics and 33controls. PCT was significantly different between the diabetics and controls and prolonged in diabetics in regard to the severity of retinopathy(p<0.05). PCT was significantly prolonged in diabetics in regard to the diabetic peripheral neuropathy and nephropathy(p<0.05). PCT was significantly different among the diabetic groups in regard to the duration of diabetes(p<0.05). Sustainde PCT was unmeasurable in 56.7% of diabetics and in 72.3% of proliferative diabetic retinopathy compared with 28.8% of controls(p<0.05). Ocular autonomic dysfunction in diabetics correlated closely with the severity of the diabetic retinopathy, diabetic petiphetal neuropathy and nephropathy, diabetic duration.
Diabetic Nephropathies ; Diabetic Retinopathy ; Peripheral Nervous System Diseases ; Pupil*

No abstract available.
Ixodes* ; Tick Bites* ; Ticks*

In order to investigate the cumulative incidence and risk factors for diabetic retinopathy among non-insulin dependent diabetes mellitus, 116 patients which given diagnosis of diabetes at age 30 years or older who had been followed-up for more than 10 years and were initially free from retinopathy were analysed retrospectively. Several risk factors for retinopathy were analysed at the initial examinations: sex, age at the onset, age at the initial examination, duration, fasting plasma glucose(FPG), two-hour postpradial plasma glucose(pp2), blood pressure, hypertension status, therapeutic regimen, total cholesterol, HDL-cholesterol, triglyceride, body mass index. After a mean follow-up time of 11.7 years. The cumulative incidence was 31.0%. By univariate analysis. Significant risk factors of retinopathy were age at the onset, age at the initial examination. FPG, PP2, therapeutic regimen. However, By using multivariate analysis. Independent risk factors were not found.
Blood Pressure ; Body Mass Index ; Cholesterol ; Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Fasting ; Follow-Up Studies ; Humans ; Hypertension ; Incidence* ; Multivariate Analysis ; Plasma ; Retrospective Studies ; Risk Factors* ; Triglycerides

BACKGROUND: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. MATERIAL AND METHOD: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9+/-14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. RESULT: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. CONCLUSIONS: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.
Aortic Valve ; Cardiac Output, Low ; Cause of Death ; Classification ; Endocarditis, Bacterial ; Female ; Hemorrhage ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Pulmonary Veins ; Reoperation ; Risk Factors ; Seoul ; Sepsis ; Survivors

PURPOSE: To determine the clinical efficacy of SS-cream, the topical agent made from the extracts of natural products for treating premature ejaculation(PE), a double blind, randomized placebo controlled phase III study on the patients with primary PE was performed in three medical centers. MATERIALS AND METHODS: Mean age of patient with primary PE was 38.7+/-0.6 years and duration of suffer from PE was 15.8+/-0.4 years. We investigated the ejaculatory latency calculated by stop watch and sexual satisfaction rate after the treatment(1 placebo and 5 SS-cream 0.2gm). Patients were instructed to apply the cream on the glans penis 1 hour before sexual intercourse in double blind randomized fashion. Clinical efficacy was compared with the prolongation of ejaculatory latency and improvement of sexual satisfaction rate. RESULTS: 106 patients with primary premature ejaculation completed this study. Mean ejaculatory latency tested at screening period was 1.37+/-0.1 min and both of patient and partner were not satisfied with their sexual lives. The mean ejaculatory latency was significantly prolonged as 10.92+/-1.0 min with SS-cream, while 2.45+/-0.3 min with placebo. In 79.8%, there was prolongation of ejaculatory latency longer than 2 minutes with SS-cream, while in 15.1% with placebo. The sexual satisfaction rate was also significantly improved as 82.2% with SS-cream, while 12.6% with placebo. 103 (16.2%) out of 636 trials of SS-cream showed mild local irritation including 82 mild burning senses and 21 mild pain, which disappeared in less than 1 hour. No adverse effect on sexual function and partner and no systemic side effects were observed. CONCLUSIONS: With these results, SS-cream is effective and safe in the treatment PE with mild local side effect.
Biological Products ; Burns ; Coitus ; Humans ; Male ; Mass Screening ; Penis ; Premature Ejaculation*

Sclerosing hemangiomas are rare benign neoplasms in pulmonary parenchyme, We analyzed CT findings of two cases of sclerosing hemangiomas of the lung in two adult females. Chest radiograph showed well-circumscuribed, round soft tissue mass with calcification in right lower lobe of one patient and without calcification and moderate or marked contrast enhancement was clearly demonstrated with CT scan. CT findings of contratst enhancement and contour of calcification allow differentiation of sclerosing hemangioma from other venign neoplasms or postinflammotory pseudotusrs of the lung.
Adult ; Female ; Histiocytoma, Benign Fibrous* ; Humans ; Lung ; Pulmonary Sclerosing Hemangioma* ; Radiography, Thoracic ; Tomography, X-Ray Computed

To investigate the effect of Laser Assisted In Situ Keratomileusis(LASIK) on Corneal endothelium, patients undergone LASIK at department fo Ophthalmology of Kangnam St. Mary`s Hospital, Catholic University Medical College from November 1997 to January 1998, were studied, retrospectively. VISX STAR laser and SCMD microkeratome were used. The corneal endothelial cell density, coefficient of variation in cell size, and hexagonality(43 eyes of 35 patients), using specular microscopy, were measured before and after 2 months and residual corneal thickness during LASIK was also measured. An average thickness of corneal bed following LASIK was 294.2+/-27.5micrometer(254.2-378.0micrometer). The changes of endothelial cell density, coefficient of variation in cell size, and hexagonality between before and after LASIK were statistically significant(P>0.05). Correlation between the change in endothelium morphology and the residual corneal thickness was not statistically significant(P>0.05). With these results, LASIK seems to be safe for myopic patients in case of the thickness of corneal bed following LASIK is over 250micrometer. However, more study is necessary to confirm the long-term effect of LASIK on corneal endothelial change.
Cell Size ; Endothelial Cells ; Endothelium ; Endothelium, Corneal* ; Humans ; Keratomileusis, Laser In Situ* ; Microscopy ; Ophthalmology ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the short- and long-term effectivensess of intracavitary urokinase with percutaneous catheter drainage in Ioculated thoracic empyemas. MATERIALS AND METHODS: 15 patients were identified as second stage of Ioculated thoracic empyema by estimating nature of pleural fluid, chest PA, lateral decubitus view and CT scan. Under the guidance of fluoroscopy or ultrasound, catheter was inserted percutaneously. Instillation of urokinase was started when amount of drained fluid became less than 30ml per day with 100,000U of urokinase mixed with 100ml of normal saline. Trial of urokinase was repeated until complete drainage of empyema was demonstrated on plain chest film obtained after 48 hours. RESULTS: Successful complete drainage was achieved in 14 of 15 patients. In long-term study, complete resorption was demonstrated in 11 of 12 patients. Average dosage of used urokinase was 330,000U and mean duration of catherter insertion was 35 days. CONCLUSION: lntracavitary urokinase with percutaneous catheter drainage is a safe and effective method to facilitate drainage of Ioculated empyema and to prevent recurrence.
Catheters ; Drainage ; Empyema ; Empyema, Pleural* ; Fluoroscopy ; Humans ; Recurrence ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

PURPOSE: The purpose of this study was to evaluate the short- and long-term effectivensess of intracavitary urokinase with percutaneous catheter drainage in Ioculated thoracic empyemas. MATERIALS AND METHODS: 15 patients were identified as second stage of Ioculated thoracic empyema by estimating nature of pleural fluid, chest PA, lateral decubitus view and CT scan. Under the guidance of fluoroscopy or ultrasound, catheter was inserted percutaneously. Instillation of urokinase was started when amount of drained fluid became less than 30ml per day with 100,000U of urokinase mixed with 100ml of normal saline. Trial of urokinase was repeated until complete drainage of empyema was demonstrated on plain chest film obtained after 48 hours. RESULTS: Successful complete drainage was achieved in 14 of 15 patients. In long-term study, complete resorption was demonstrated in 11 of 12 patients. Average dosage of used urokinase was 330,000U and mean duration of catherter insertion was 35 days. CONCLUSION: lntracavitary urokinase with percutaneous catheter drainage is a safe and effective method to facilitate drainage of Ioculated empyema and to prevent recurrence.
Catheters ; Drainage ; Empyema ; Empyema, Pleural* ; Fluoroscopy ; Humans ; Recurrence ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

Laser Assisted In Situ Keratomileusis(LASIK) has been regarded as an effective treatment for the correction of high myopia. However, excimer laser refractive procedure, itself modifies the refracting power of the cornea by altering the anterior corneal curvature using photoablation. Therefore, The cornea treated by refractive surgery has a potentiality to be in pathologic condition. To impove effectiveness of LASIK, it is required to examine corneal state before operation using slit-lamp biomicroscopy, keratometry, photokeratoscopy, and topography. Also, a careful and conservative approach that ideally preserves 250 of posterior stromal bed after Lasik should be used until further research or experience indicates that corneal intergrity is pressved with less posterior tissue. In this study, we report two cases of corneal ectasia which cannot be anticipated before LASIK and appeared as a typical cornneal ectasia after LASIK. We reviewed useful methods to detec subclinial pathologic conditions of cormea prior to LASIK with literature and also recommed proper operative procedure to prevent cormeal ectasi after LASIK.
Cornea ; Dilatation, Pathologic* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Refractive Surgical Procedures ; Surgical Procedures, Operative