No abstract available.
Cautery* ; Pneumothorax* ; Thoracoscopes*

Adenocarcinoma of the bladder is a rare tumor. It's incidence figures in the ranges of 0.5 to 2.0 percent of all epithelial bladder neoplasms. Adenocarcinoma of the bladder occurs more frequently in areas which schistosomiasis is endemic and is the most common malignant tumor arising in the exstrophic bladder or urachus. Primary adenocarcinoma of the bladder must be carefully differentiated from the adenocarcinomas that originate within the urachus, prostate, seminal vesicle, breast, gastrointestinal tract or other organs. This report describes a 43 years old male who was diagnosed as an infiltrative adenocarcinoma of the bladder by the preoperative evaluation and transurethral resection of bladder and was confirmed by the pathologic examination following pelvic exenteration as the primary adenocarcinoma or the bladder extended to the prostate and rectum and was followed by chemotherapy without evidence of metastasis.
Adenocarcinoma* ; Adult ; Breast ; Drug Therapy ; Gastrointestinal Tract ; Humans ; Incidence ; Male ; Neoplasm Metastasis ; Pelvic Exenteration* ; Prostate ; Rectum ; Schistosomiasis ; Seminal Vesicles ; Urachus ; Urinary Bladder Neoplasms ; Urinary Bladder*

The extraction rates of biogenic amines such as 5-hydroxytryptamine(5-HT) and norepinephrine(NE) in pulmonary endothelium, and the permeability of human serum albumin(HSA) to pulmonary epithelium were measured in experimental adult respiratory distress syndrome(ARDS), in order to evaluate their usefulness for the early recognition of ARDS. Sixteen mongrel dogs(body weight, 13+/-0.9 kg) were divided into 3 groups; Oleic acid 0.06 ml/kg was injected to 6 dogs(M group) and oleic acid 0.12 ml/kg to 6 dogs(S group). Four dogs were used as a control group. The extraction rates(%) of 14C-5-HT and 3H-NE, the blood concentration of (99m)Tc-HSA, hemodynamic changes and changes of arterial gas profile were measured and compared among three groups. In control group with 100% oxygen ventilation, the extraction rates of 14C-5-HT, 3H-NE and the blood concentration of 99mTc-HSA were not changed. In M group, the extraction rate(%) of 14C-5-HT was decreased from 61.5+/-3.1 to 43.8+/-5.2 in 10 minutes, and such decreased extraction rate(%) was maintained for 2 hours. The extraction rate(%) of (3)H-NE was decreased from 32.3+/-3.6 to 19.5+/-2.5 in 10 minutes. In S group, the extraction rate(%) of 14C-5-HT was decreased from 60.9+/-5.1 to 23.2+/-5.7 in the first 10 minutes, and the extraction rate(%) of H-NE was decreased from 30.1+/-4.3 to l3.1+/-1.9 in 10 min, and decreased slowly thereafter. The blood concentration of 99mTc-HSA was decreased significantly in M group and more in S group compared with control group during two-hour observation. These results suggest that measuring extraction rates of biogenic amines couid be applied for early recognition of ARDS, however, the change of blood 99mTc-HSA concentration could not be applied for early recognition of ARDS, because it has poor correlation to the progression of respiratory failure.
Adult ; Animals ; Biogenic Amines* ; Dogs* ; Endothelium ; Epithelium ; Hemodynamics ; Humans ; Oleic Acid ; Oxygen ; Permeability* ; Respiratory Insufficiency* ; Serum Albumin* ; Technetium Tc 99m Aggregated Albumin ; Ventilation

We have encountered many patients with dermatologic problems caused by animals, but there are not so many systematized literature about them in Korea. Since these causative animals are different from foreign animals in their distribution and habitat, there have been much difficulties in making diagnosis and in studying them based on foreign literature. We have undertaken this study to get the basic material for the possible causative animals in Korea by comparing with foreign literature, searching out the books of zoological claasification, and through personal contacts. One hundred and five species are found to be identical with the species reported in foreign literature, but 324 species are not, although they could be placed in the same genus.
Animals* ; Diagnosis ; Ecosystem ; Epidemiologic Studies* ; Humans ; Korea* ; Skin Diseases* ; Skin*

A clinical experience was made on 14 patients of penis carcinoma admitted to the Department of Urology. Chosun University Hospital during the period from January, 1979 to December, 1987 and following results were obtained. 1. The incidence of penile carcinoma was 0.6% of total inpatients of the Urologic Department and 5.8% of genitourinary tract cancer. 2. Age distribution was between 42 and 78, showing highest incidence at 50-59 years old. 3. Clinical findings were ; mass 71.5%, ulcer 21.4% and inguinal lymphadenopathy 57%. 4. Clinical stages were distributed as follows : 2 cases in stage I, 6 cases in stage II, 5 cases in stage III, and 1 case in stage IV. 5. Surgical treatment were partial amputation only in 6 cases, partial amputation with lymph node dissection in 3 cases, total penectomy and lymph node dissection in 2 cases, total penectomy only in 1 case, circumcision only in 1 case. 6. Biopsy were performed in 7 cases whose lymph node were palpable and 4 cases were positive for metastasis (57.1 %).
Age Distribution ; Amputation ; Biopsy ; Circumcision, Male ; Female ; Humans ; Incidence ; Inpatients ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Neoplasm Metastasis ; Penis* ; Ulcer ; Urology

PURPOSE: To evaluate the effectiveness of intreaepithelial photorefractive keratectomy (IE-PRK) for the treatment of myopic regression after laser in situ keratomileusis (LASIK) METHODS: 38 eyes of 22 patients who had previous LASIK for myopia were selected and retreated with IE-PRK, in which a photoablation was performed directly in the epithelium without damage to Bowman's layer. All eyes were elapsed at least 6 months after the LASIK. Follow-up was up to 6 months and within +/-0.50 of emmetropia on 6 months after surgery was considered as a success. RESULTS: Before IE-PRK, the eyes regressed to a mean of .1.26+/-0.45 D spherical equivalent (SE). The mean SE at 1 week after IE-PRK was .0.44+/-0.88 D, 1 month was .0.59+/-0.45 D, 3 month was .0.63+/-0.41, 6 month was .0.62+/-0.43 (p<0.05). 23 of the 38 eyes (60.5%) had refraction within +/-0.50 and were considered as successfully treated. Preoperative mean best corrected visual acuity (BCVA) was 0.33+/-0.18 (Snellen equivalent) and final mean BCVA was 0.77+/-0.99 (p<0.01). There were no significant complications of corneal flap. CONCLUSIONS: The results of this study indicate that intraepithelial photorefractive keratectomy appears to be a safe means for treating patients for regression after LASIK procedure. But success rate was not so good as the enhancement. Controlled studies with larger population will be necessary to evaluate the accuracy of the method more correctly.
Emmetropia ; Epithelium ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia ; Photorefractive Keratectomy* ; Visual Acuity

PURPOSE: To compare results of laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) for the treatment of high myopia. METHODS: In this study, 129 patients with a manifest refraction over -6.00 diopters were assigned two groups for 144 eyes of 72 patient treated with LASIK and 114 eyes of 57 patients treated with LASEK. Uncorrected visual acuity, manifest refraction, corneal haze and other complications were reviewed in LASIK- and LASEK-treated eyes at 6 months after the operation. RESULTS: At the 6-month follow-up, there were significant between-eye differences in uncorrected visual acuity and mean spherical equivalent. And LASEK-treated eyes had more corneal opacity and it makes decreased uncorrected visual acuity. CONCLUSIONS: Both laser refractive surgeries were safe and effective methods to treat eyes with high myopia. But LASIK procedure may prove superior to decrease corneal opacity and visual predictability.
Corneal Opacity ; Follow-Up Studies ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ* ; Myopia* ; Refractive Surgical Procedures ; Visual Acuity

No abstract available.
Nasal Bone*

Mechanical ventilation is widely used for the respiratory support in patients with acute respiratory insufficiency. Extracorporeal respiratory support using a membrane oxygenator has been developed to relieve refractory hypoxemia or hypercapnea under conventional ventilatory management. It has been called extrcorporeal membrane oxygenation (ECMO), extracorporeal carbon dioxide removal (ECCO2R) or extracorporeal lung assist (ECLA). Venoarterial (VA) ECLA drains blood from a catheter placed in the right atrium via the internal jugular vein and perfuses through a cannula at the level of the aortic arch via the right common carotid artery. While VA ECLA supports the heart as well as the lungs, but it has the disadvantage of requiring carotid artery ligation. In venovenous (VV) ECLA, perfusion cannula is placed at a large vein and the carotid artery is not ligated. In addition there is theoretical advantage of perfusing the well oxygenated blood to pulmonary artery. We hypothesized that VV ECLA is as effective as VA ECLA in the oxygenation of arterial blood when the respiratory insufficiency does not accompany heart failure. A model of acute respiratory failure was induced on 6 dogs by the injection of oleic acid 0.07 ml/ kg. Two hours later, acute hypoxemia and hypercapnea were identified with acute hemorrhagic pulmonary edema, but the hemodynamic parameters were stable for 2 hours. Oleic acid 0.07 ml/kg was injected on another 7 dogs. A double lumen tube and a perfusion cannula were introduced via the right external jugular vein and the carotid artery, respectively. The outer lumen of a double lumen tube was used for the drainge of both VV ECLA and VA ECLA. Mixed venous oxygen tension (PvO2) was higer in VV ECLA than in VA ECLA, but arterial oxygen tensian (PaO2) in VV ECLA was as high as that in VA ECLA. It could be concluded that VV ECLA using a double lumen tube can be used as an alternative to VA ECLA for the respiratory support of acute respiratory failure.
Animals ; Anoxia ; Aorta, Thoracic ; Carbon Dioxide ; Carotid Arteries ; Carotid Artery, Common ; Catheters ; Dogs* ; Extracorporeal Membrane Oxygenation* ; Heart ; Heart Atria ; Heart Failure ; Hemodynamics ; Humans ; Jugular Veins ; Ligation ; Lung* ; Membranes ; Oleic Acid ; Oxygen ; Oxygenators, Membrane ; Perfusion ; Pulmonary Artery ; Pulmonary Edema ; Respiration, Artificial ; Respiratory Insufficiency* ; Veins

Midazolam, an imidazobenzodiazepine derivative, is utilized as a premedicant, sedative and anesthetic induction agent. Cnmpared to diazepam, midazolam is characterized by better solubility in water, better venous tolerance and a more rapid onset of action. Though the onset of pharmacological action of midazolam takes longer than thiopental, midazolam exerts more gradual effects on circula- tion than thiopental. Because it maintains hemodynamic stability and induces amesthesia smoothly, madazolam is a potential alternative as an induction agent in high-risk patients. To evaluate the safe margin of i. v. midazolam and to investigate the effect of carbon dioxide retention by midazolam, 32 cardiac patients were divided into 4 groups: Group I, midazolam 0.2 mg/ kg with spontaneous respiration: Group II, midazolam 0.2 mg/kg with assist respiration: Group III, midazolam 0.4 mg/kg with assist respiration: Group IV, midazolam 0.4 mg/kg with spontaneons respiration. In each group, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, cardiac output and arterial blood gas analysis were checked before and 2,4 and 6 minutes after i. v. injection of midazolam. Systolic blood pressure decreased significantly after injection of midazolam in all four groups. Diastolic blood pressure decreased significantly in group II and IlI. Systolic blood pressure was lower in group III than II 4 and 6 minutes following midazolam administration. The elevation of arterial carbon dioxide tension in group I and IV did not cause any changes in cardiovascular variables. The time from the end of injection of midazolam to spontanous closing of eyes and the time from the end of injection to disappearance of eyelash reflex were measured. But there were no significant differen-ces between all four groups. .On the basis of these data, we could conclude that in unpremedicated patients for open heart surgery midazolam alone allows rapid and smooth induction. In case of using the dose of 0.4 mg/kg, care must be taken in the decrease of systolic blood pressure.
Blood Gas Analysis ; Blood Pressure ; Carbon Dioxide ; Cardiac Output ; Diazepam ; Heart Rate ; Heart* ; Hemodynamics ; Humans ; Midazolam* ; Reflex ; Respiration ; Respiratory Rate ; Solubility ; Thiopental ; Thoracic Surgery*