The 40 cases of eye tumors were excised and studies histologically between January 1, 1965 and December 31, 1974 at department of ophthalmology, national medical center. The sexual distribution reTealed 21 males(52.5%) and 19 females(47.5%). For the evaluation of the site of the involved eye 19 cases(47.5%) were left eye, the right eye was 18 cases(45%) in the monocular involvement and the binocular was 3 cases(7.5). The benign tumors were more treguent in 1st, 2nd and 3rd decades, but the malignant tumors, on the other hand. after 5th decade. Location wise, the eyelid was largest in number(11 cases 27.5%) followed by the retina(10 cases 25%), conjunctiva(9 cases 32.5%), orbit(9 cases 22.5%) and lacrimal opparatus(1 case 2.5%) in order. As a single disease, the retinoblastoma, Sq cell ca, Nevus, cyst and pseudotumor were impressively high in incidence. (As the incidence of the tumor, Retinoblastoma 10 cases(25%), Sq cell ca 4 cases(10%), Nevus 4 cases(10%), cyst 4 cases(10%) and pseudotumor was 3 cases(7.5%)), Over all incidence of malignant tumor was 45%(18 cases) and that of benign tumor 55%(22 cases).
Eyelids ; Hand ; Incidence ; Nevus ; Ophthalmology ; Retinoblastoma ; Telescopes

A rare case, 11 aged girl who had extensive persistent pupillary membrane such like mushroom appearance in both eye with disturbance of cefitral vision was experienced.
Agaricales ; Female ; Humans ; Membranes*

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

One lung ventilation with a double lumen endobronchial tube during thoracic anesthesia is necessary for the protection of the healthy lung from contamination by the diseased lung and offers acceptable conditions for the surgeon. During one lung ventilation hypoxemia can frequently occur even with the administration of 100% oxyge. Recently we experienced markedly improved oxygenation during one lung anesthesia with a right sided double lumen endobronchial tube with application of CPAP 10cmH2O in the nondependent lung in a left lower lung brochiectatic patient. The healthy dependent right lung was ventilated by a conventional mechanical ventilator with FiO2 1.0, tidal volume 10ml/kg and respiration rate 12/min. Anesthesia was maintained with O2-halothane. Fifteen minutes after two lung ventilation in the right lateral decubitus position, the PaO2 and PACO2 were 400 and 33 torr respectively. 15 minutes after one lung ventilation PaO2 decreased to 99 torr. 15 minutes following application of CPAP 10cmH2O, the PaO2 increased to 229 torr, 30 minutes after CPAP 331 torr, and 2 hours after CPAP it rose to 373 torr. The nondependent lung was motionless and slightly expanded, and the surgical field was suitable for surgery.
Anesthesia ; Anoxia ; Bronchiectasis* ; Humans ; Lung* ; One-Lung Ventilation ; Oxygen ; Respiratory Rate ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

During surgical repair of a descending thoracic aorta aneurysm, one-lung ventilation improves visualization of the surgical field, facilitates surgical resection, and reduces lung trauma. Trauma to the left lung during surgical repair of the descending thoracic aorta is very common, and intrapulmonary hemorrhage can be occurred if both lungs are ventilated. A double lumen tube can isolate and protect the lungs. During one lung ventilation in the lateral decubitus position, hypoxemia can frequently occur and hypoxic damage can result. Selective nondependent lung high frequency jet ventilation was administered using a MERA JET VENTILATOR with FiO2 1.0, driving gas pressure 1kg/cm2, respiration rate 120/min., and an I:E ratio of 1:2. Oxygenation (PaO2 readings were all above 200 torr) was well maintained and PaCO2 values were all within normal limits throughout the operation. Under the left atrial femoral artery bypass with the cardiopulmonary bypass machine without oxygenator, an internal bypass graft with Woven dacron was performed. The patient tolerated the surgery well, and the postoperative course was uneventful except for left vocal cord paralysis.
Aneurysm* ; Anoxia ; Aorta, Thoracic* ; Cardiopulmonary Bypass ; Femoral Artery ; Hemorrhage ; High-Frequency Jet Ventilation* ; Humans ; Lung* ; One-Lung Ventilation ; Oxygen ; Oxygenators ; Polyethylene Terephthalates ; Reading ; Respiratory Rate ; Transplants ; Ventilators, Mechanical ; Vocal Cord Paralysis

Cardioplegic myocardial protection has become the most popular method for coronary artery bypass surgery. In contrast, we reported 17 consecutive coronary artery bypass operations with ventricular fibrilation, nitroglycerine infusion, and moderate hypothermia. The average patients age was 55 years. 11 patients had stable angina, 4 patients unstable angina, 2 patients varient angina, and 6 patients had prior myocardial infarcation. On cardiac catheterization, the mean LVEDP was 17.32+/-2.13mmHg, EF was 0.67, and abnormal LV wall motion was noted in 5 patients. Premedication usually consisted of hydroxyzine 1~3mg/kg with or without morphine 0.05~0.1mg/kg IM. Induction agents was morphine sulfate, diazepam, lidocaine and pancuronium for muscle relaxant. Maintaninance agents were nitrous oxide, morphine with small dose of halothane or enflurane. Almost all case (15 patient) was infused nitroglycerine 0.5~1.5 microg/kg throughout entire procedure. After bypass, average patient's temperature maintained 25~28 degrees C, and ventricular fibrillation were induced with or without cold saline irrigation around the heart. Average mean arterial pressure were maintained 60~80 mmHg during bypass period. At the end of bypass, if spontaneous beating were not occurred under normal temperature, defibrillation were used. After bypass stop, methylprednisolone were injected in 15 patients. Average anesthetic time was 585 min., surgery time was 529 min, bypass time was 237 min. Arterial blood gas and electrolyte was acceptable range during all period. Complication implicated with anesthesia was myocardial infarction (3 patient), arrhythmia and transient vocal cord paralysis, 1 patient, respectively and no mortality. In all cases the anginal pain was improved.
Anesthesia ; Angina, Stable ; Angina, Unstable ; Arrhythmias, Cardiac ; Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diazepam ; Enflurane ; Halothane ; Heart ; Humans ; Hydroxyzine ; Hypothermia ; Lidocaine ; Methylprednisolone ; Morphine ; Mortality ; Myocardial Infarction ; Nitroglycerin* ; Nitrous Oxide ; Pancuronium ; Premedication ; Ventricular Fibrillation* ; Vocal Cord Paralysis

Lymphangioma occuring in the gastrointestinal tract is a rare benign tumor, which is composed of lymphatic vessels of various size. A sharply demarcated smooth, soft, cystic submucosal tumor which is easily compressible and covered with normal mucosa is a characteristic eadoscapic feature. Recently, we experienced a case of lymphangioma in ascendmg colon and removed it successfully by colonoscopic snare polypectomy.
Colon ; Colonoscopy ; Gastrointestinal Tract ; Intestine, Large* ; Lymphangioma* ; Lymphatic Vessels ; Mucous Membrane ; SNARE Proteins

PURPOSE: Peritoneal seeding is the most common type of metastasis and recurrence in gastric cancer. Recently, some studies have reported the benefits of a noncurative gastrectomy for greatly advanced gastric cancer; nevertheless, there are many controversies. This study was performed to investigate the survival benefit of a noncurative gastrectomy for patients with greatly advanced gastric cancer with peritoneal seeding. METHODS: We retrospectively analyzed 286 gastric-cancer patients who had received operations and who had been proven to have peritoneal seeding without liver metastasis or other hematogenous distant metastasis between January 1990 and December 1997 at the Department of General Surgery, College of Medicine, University of Ulsan. RESULTS: The distribution of the degree of peritoneal seeding was P1 in 84 cases (29.4%), P2 in 56 cases (19.6%), and P3 in 146 cases (51.0%). The duration of median follow-up was 9 months (range: 0.4-83.9 months). A noncurative gastrectomy was performed in 121 cases (42.3%); out of them, a total gastrectomy was performed in 49 cases (40.5%), a distal gastrectomy in 70 cases (57.9%), and a proximal gastrectomy in 2 cases (1.6%). A noncurative gastrec tomy was done 51 of the P1 cases (60.7%), 23 of the P2 cases (41.1%), and 47 of the P3 cases (32.2%). D2 lymph-node dissection was performed in 168 cases (87.6%). Postoperative complications developed in 5 cases with a noncurative gastrectomy, and there was no operative mortality. The median survival times were 11.3 months in P1 cases, 10.5 months in P2 cases, and 6.6 months in P3 cases. The median survival times of noncurative gastrectomy, bypass, and expoloratory laparotomy cases were 11.5 months, 6.6 months, and 6.3 months, respectively; according to the degree of peritoneal seeding, they were 14.8 months, 7.1 months, and 5.3 months in P1 cases, 15.3 months, 8.2 months, and 12.5 months in P2 cases, and 7.6 months, 6.4 months, and 5.7 months in P3 cases, respectively. The difference in survival time between the resection and the nonresection groups had statistical significance regardless of the degree ofperitoneal seeding (p<0.05). In the multivariate analysis, the degree of peritoneal seeding (RR: 1.33) and gastric resection (RR: 1.52) were proven to be significant prognostic factors. CONCLUSION: A noncurative gastrectomy might lengthen the survival time in advanced gastric-cancer patients with peritoneal seeding.
Follow-Up Studies ; Gastrectomy ; Humans ; Laparotomy ; Liver ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Ulsan

Pulse oximetry is a relatively new and noninvasive technique for measuring O2 saturation continuously. We applied pulse oximetry to 9 pediatric patients with tetralogy of Fallot during shunt surgery. Arterial blood gas tensions were measured at the time of postinduction, just before insertion of the shunt, after the shunt and at the end of the operation. The SaO2 levels by blood gas analysis were compared with the SpO2 levels as measured by pulse oximetry. SaO2 and SpO2 levels increased after the shunt and at the end of the operation in comparison with before the shunt, but the PaO2 level remained the same in each period. The SaO2 and SpO2 levels were identical in all 4 periods. The pH increased at the end of the operation in comparison with the postinduction. In conclusion, continuous monitoring of SpO2 through pulse oximetry, instead of PaO2 is a very useful method to assess the adequacy of perfusion after the shunt. Pulse oximetry is also a valuable tool with which to choose the site of the pulmonary artery to be shunted.
Blood Gas Analysis ; Humans ; Hydrogen-Ion Concentration ; Oximetry* ; Perfusion ; Pulmonary Artery ; Tetralogy of Fallot*