No Abstract Available.
Cataract*

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

No abstract available.
Carcinoma, Papillary*

No abstract available.
Dacryocystorhinostomy*

The purpose of our study was to compare the clinical results between arthroscopic bone fixation on intertubercular groove using suture anchor and soft tissue fixation at the rotaor interval for biceps tenodesis when partial tear or instability of biceps tendon accompanied with rotator cuff tear. From January 2010 to January 2012, 34 cases who were performed biceps tenodesis for partial tear or instability were enrolled in our study. Mean follow-up period was 30.2 months. Bone fixation using suture anchor was performed in 18 cases, and soft tissue fixation was performed in 16 cases. Clinical result was evaluated by pain visual analogue scale (VAS), Speed test, Yergason test, muscle strength, and Constant score. Pain VAS of cases with soft tissue fixation was significantly higher than that of cases with bone fixation at 6 months and final follow-up. Positive results for the final follow-up Speed and Yergason test were checked in 4 cases (25%) with soft tissue fixation and 1 (5.6%) with bone fixation. The Popeye deformity was seen in 4 cases (25%) with soft tissue fixation and 2 (11%) with bone fixation. Constant score was improved 47 to 78 in cases with soft tissue fixation and 48 to 86 in cases with bone fixation. In patient with partial tear or instability of biceps tendon accompanied with rotator cuff tear, biceps tenodesis using soft tissue fixation showed worse result compared with bone fixation because of long duration of the pain. Therefore, when performing the biceps tenodesis, bone fixation will be recommended.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Muscle Strength ; Rotator Cuff ; Shoulder ; Suture Anchors ; Tendons ; Tenodesis* ; Tissue Fixation

Surgery represents a noxious stimulus to the body, which responds to the injury in the form of an endocrine metabolic reaction. This stress responsehas usually been considered to be a homeostatic defence mechanism by which the body protects itself against injury. This study was primarily undertaken to observe the modulation of stress response to the surgical stimuli under the effects of general and spinal anesthesia by measuring endogenous catecholamines. Fifteen pateints scheuled for elective surgical procedures on the lower half of the body were divided into two group: general and spinal anesthesia groups. No premedication was given to any patient. After the patient was laid down the surgical table, intravenous line was placed and secured in an antecuhital vein for maintenance of fluid and obtaining blood samples. After the intravenous cathether was inserted and a 10-minute rest period was allowed for reassurance, the first baseline sample was obtained for measurement of catecholamines and then anesthesia was induced. .General anesthesia group: Anesthesia in five patients was induced with sodium thiopental (5 mg/ kg), succinylcholine (1 mg/kg) followed by endotracheal intubation and was maintained with halothane, N2O and muscle relaxation using pancuronium. Spinal anesthesia group: Spinal anesthesia in ten patients was performed in a sitting position at L3-L4 intervertebral space using lidocaine 50-150 mg. The anesthesia level was determined by a pinprick test. Subsequent samples were obtained at 30 minutes after the surgical incision and in the recovery room at least 60 minutes after the discontiuation of inhalational anesthesia or after recovery of senastion and motor function of the lower extremites. Mean arterial pressure was measurd by a noninvasive automatic blood pressure monitor. Plasma epinephrine and norepinephrine were measured by Peuler and Johnson radioenzymatic method. The results are summerized as follows: Inhalation anesthesia group: Plasma norepinephrine was increased during surgery and epinephrine was increased during the postoperative recovery period. Spinal anesthesia group: Plasma norepinephrine and epinephrine were not increased during the intra and postoperative periods. High spinal anesthesia resulted in a suppression of both plasma norepinephrine, epinephrine with a fall of mean arterial pressure but no changes of norepinephrine, epinephrine, or mean arterial pressure were observed in the patients receiving low spinal anesthesia. There was a relationship between the sensory dermatome anesthesia level and changes of both plasma norepinephrine (r=0.748, P<0.01)and epinephrine (r=0.667, P<0.05). There is a relationship between changes of blood pressure and plasma norepinephrine levels during spinal anesthesia and inhalational anesthesia (r=0.827, p<0.01). The effect of spinal anesthesia on adrenergic tone depends on the level of anesthesia. The catecholamine responses to surgical stress were prevented by low spinal anesthesia which had no supression of efferent adrenergic tone. Therefore, low spinal anesthesia maybe useful to prevent adrenergic responses to surgical stress in high-risk patients scheduled for surgery on the lower half of the body.
Anesthesia* ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Spinal ; Arterial Pressure ; Blood Pressure ; Blood Pressure Monitors ; Catecholamines ; Epinephrine ; Halothane ; Humans ; Intubation, Intratracheal ; Lidocaine ; Muscle Relaxation ; Norepinephrine ; Pancuronium ; Plasma* ; Postoperative Period ; Premedication ; Recovery Room ; Sodium ; Succinylcholine ; Surgical Procedures, Elective ; Thiopental ; Veins

The purpose of this study was to determine the beneficial effect of treatment with methylprednisolone sodium succinate on the cytochrome oxidase activity and lipid peroxidation during 4 hour after 400gm-cm injury to the cat spinal cord. The contusion injury was associated with a decrease of the cytochrome oxidase activity of the gray matter and an increase of the lipid peroxidation. A significant drop in cytochrome oxidase activity to about 40% of normal level was observed as early as 15 minutes after injury and the lowest activity was reached at 1 hour postinjury, but at 4 hours after injury the level of the activities of the enzyme was increased or stabilized. An increase of lipid peroxidation began as early as 15 minutes after the injury and the highest concentration was reached at 4 hour of postinjury. An intravenous dose of 30mg/kg methylprednisolone sodium succinate was administered immediately after the injury. The significant increased of the cytochrome oxidase activity and concomitant decrease of the lipid peroxidation were found in cats of the treated methylprednislone. These results suggest that the beneficial effects of 30mg/kg dose administration of the methylprednisolone are an enhancement of cytochrome oxidase activity, ie., the mitochondria function and an attenuation of lipid peroxide formation, as the result of the inhibition of the O2-free radial reaction.
Animals ; Cats ; Contusions ; Cytochromes* ; Electron Transport Complex IV* ; Lipid Peroxidation* ; Methylprednisolone Hemisuccinate ; Methylprednisolone* ; Mitochondria ; Spinal Cord Injuries ; Spinal Cord*

The purpose of this study to determine the therapeutic effect of nimodipine(N.P.) and methylprednisone(M.P.) on the changes of cytochrome oxidase activity(COA) and lipid peroxidation(L.P.) in the acute phase of focal cerebral zschenia. Acute focal cerebral ischemia was induced by transorbital occlusion of proximal part of the left middle cerebral artery(MCA) with Heifetz clip under the operating microscope. The experimental animals were devided into 6 groups. The occlusion group was that the acute focal ischemia was induced by 4-hour of occlusion of the MCA only. The circulation group was that of 2-hour recirculation after acute focal ischemia. The steroid treatment group was that of M.P.(15 mg/kg) initial intravenous injection at 30 minutes after occlusion and then repeated injection at intervals of one half hours. The N.P. treatment group was that of continuous intravenous N.P.(1 microkilogram/min) infusion, initiated 30 minutes after induction of the ischemia. The combined treatment group was that was treated with intravenous infusions of M.P. as the same procedures with the M.P. and N.P. treatment groups. The sham control group was the animals with removal of the orbital contents with no occlusion of MCA. The results obtained were as follows : In the steroid treatment group COA was significantly increased to 189.76% and L.P. significantly reduced to 53.14% and the N.P. treatment groups COA was significantly increased to 170.88% and L.P. significantly reduced to 56.20% of the values of the occlusion group, respectively. In the combined treatment group COA was very significantly 220.35% and L.P. reduced highly significantly decreased to 48.85% of the values of the occlusion group. It can be concluded the above results indicate the therapy of N.P. combination with M.P. has the therapeutic effect in the management of acute focal ischemia of this cat model.
Animals ; Brain Ischemia* ; Calcium* ; Cats* ; Electron Transport Complex IV ; Infusions, Intravenous ; Injections, Intravenous ; Ischemia ; Lipid Peroxidation ; Methylprednisolone ; Orbit

BACKGROUND: Superficial fungal infections are common diseases acid the prevalence of superficial fungal diseases are not static but change under the influence of various forces such as climate, migration of peoples and development in prophylaxis and therapy. OBJECTIVE: To investigate the present status of superficial dermatiphytoses and some changes on the frequency of the diseases, sex distributions and varieties of the casiative organisms. MEHTODS: The clinical and rnycological aspects of superficial fungal diseases of 3,222 patients from July 1989 to June 1992 were analyzed. Results : 1) The incidence of superficial fungal diseases was 25.4% of total out-patients. 2) The superficial fungal diseases showed a higt incidence in the third(26.4%) and the fourth decade(24.3%). 3) The ratio of male to female was 2.11:1(2,188:1,034). 4) The monthly prevalence of super ficial fungal diseases was high inhuly(17.8%), August(15.2%) and June(1.7%). 5) The incidence of superficial fungal diseases in order of frequency were tinea pedis ,28.1%, tinea cruris(19.5%), onychomycosis(15.6%), tinen orporis(11.5%), tinea manus(7.8%), tinea versicolar(7.8%), candidiasis(7.4%) and tinea capitis(2.3%), 6) Coexisting fungal infections were found in 644 patients(19.9%) and the case of tinea pedis with onychomycosis was the most common. 7) The positive rate of KOH scraping was 54.0% and the positive rate of culture on ordinary Salourauds dextrose agar media was 42.7%. 8) Trichophyton rubr,im was the most common causative orantism of superficial dermatophytes(38.4%), and other in decreasing frequency were Candida albicans(36.9%), Trichophyton mentagrophytes(23.6%) Microsporum canis(0.7%), Trichophyton ferrvgiteum(0.3%) and Epidermophyton floccosum(0.1%). CONCLUSION: These results are not significantly different from those iif previous studies. But the incidence rate of the superficial pungal diseases(25.4%) were higher thar, previous studies and showed a high incidence in young male patients and in the summer. The positiv rate of KOH scraping(54.0%) was lower than previous studies. The most common causative organism was Trichophyton rubrum(38.4 %).
Agar ; Candida ; Climate ; Epidermophyton ; Female ; Glucose ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Prevalence ; Sex Distribution ; Tinea ; Tinea Pedis ; Trichophyton

We have experienced an unusual case of hemorrhagic renal cyst in the rt. kidney at 58 years old woman. The Rt. kidney was enlarged, and showed a few subcapsular ischemic areas The color of kidney was dark brown. As the cyst at lower pole of rt. kidney was dissected, hemorrhagic fluid visualized in the cystic cavity. The final pathologic finding was renal cyst associated with malignant change and renal cell carcinoma at another renal parenchyma. Herein, hemorrhagic renal cyst, a rare clinical entity, was reported with review of literatures.
Carcinoma, Renal Cell ; Female ; Humans ; Kidney ; Middle Aged