No abstract available.
Urinary Bladder* ; Vasoactive Intestinal Peptide*

No abstract available.
Arm* ; Free Tissue Flaps*

Salmonella osteomyelitis is uncommon and it often develops in patients with sickle cell anemia and other hemoglobinopathy. Especially, osteomyelitis caused Salmonella typhi in a nonsickle cell patients is a very rare event. We report three cases with review of literature.
Anemia, Sickle Cell ; Hemoglobinopathies ; Humans ; Osteomyelitis ; Salmonella typhi ; Salmonella

Recently, the number of surgeries with age-related cataracts has increased remarkably high due to the safety of modern cataract surgery and reliable post-operative visual function has been widely recognized by patients. In spite of such an increase in the number of patients, the authors specualtes that there are still many cataract patients with highly deteriorated visual function who havehad no occasion to receive an ocular examinatio. In order to screen such patients during their general health examination, the authors` study group experienced and evaluated the simplified cataract screening system recently proposed by Sasaki et al, Kanazawa Medical University in Japan. The cataract screening system consists of two steps; primary screening system is 12-item questionnaires, and far vision. In order to evaluate the screening system in Korea, it was used to test 224 indivisual who had wanted to be examined ophthalmologically in two area, Yongsan, Seoul and Donghae, Gangwondo province. Initially, well-trained nurse did the screening system, and then the same patients were examined by one ophthalmologist. The agreement ratio between the screening test and the final judgement for cataract was 70.8% and the final cataract-screening rate was 95.1%. Based on these results, the authors propose the possibility of clinical use of this screening system in general health care units.
Cataract* ; Delivery of Health Care ; Gangwon-do ; Humans ; Japan ; Korea ; Mass Screening* ; Surveys and Questionnaires ; Seoul

The authors present that was diagnosed late panophthalmitis histopathologically and that was a case of 17 scheie's filtering operated eyes during last 2 years. The patient was 63 year-old male who had chronic narrow angle glaucoma associated with moderate optic nerve cupping and atrophy in both eyes a year ago. Good filtering bleb showed and intraocular pressure controlled well normally after Scheie's operation in right eye. One year and five months later acute suppurative endophtbalmitis occured in operated eye during catarrhal conjunctivitis in both eyes. The authors concluded that the route of infection was filtering fleb. Culture of excreting pus through ruptured filtering fleb was negative.
Atrophy ; Blister ; Common Cold ; Conjunctivitis ; Glaucoma* ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Optic Nerve ; Panophthalmitis ; Suppuration

Cataract and refractive surgical procedures are now among the most common and successful in medicine. A clear understanding of the current situation and future trends in these fields has become increasingly important. Since 1995, we have annually surveyed the members of the Korean Society of Cataract and Refractive surgery(KSCRS) about cataract surgery technique, anesthesia, intraocular lens and refractive surgery. Third annual survey forms consisted of 71 multiple-choice questions were mailed in January 1998 to 180 ophthalmologist members of the KSCRS. Approximately 44% of the questionnaires mailed were returned by the February cutoff date. Current data were compared with data in previous annual survey. Over half of the respondents(52%) were in forties. Most of the cataract operation(83%) was carried out on hospitalized patients. Use of a retrobulbar with akinesia for cataract was 49%, and use of topical anesthesia increased from 5% in 1995 to 17% in 1996. Eight-one percent of surgeons used phacoemulsification for more than half of their patients. Selfsealing wound construction was main wound closure technique in phacoemulsification for 44%. The type of intraocular lens used for small incision cataract surgery included silicone(64%), small round PMMA(polymethyl methacrylate, 21%), and acrylic(11%). Sixty-three percent of surgery. From the answers to the survey, we found current trend and these results are valuable information to all ophthalmologists.
Anesthesia ; Cataract* ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Refractive Surgical Procedures* ; Wound Closure Techniques ; Wounds and Injuries ; Surveys and Questionnaires

At the present time, lidocaine is commonly used in ophthalmic surgery as a local anesthetic. Although it is safer than general anesthesia, visionthreatening and even life-threatening side effect can occur rarely. We report one case of visual loss combined with severe neurologic damage after local injection of lidocaine. Fifty-year-old male patient underwent phacoemulsification and IOL transscleral implantation with unplanned anterior vitrectomy after Nadbath-Ellis akinesia and retrobulbar anesthesia with lidocaine with 1:100,000 epinephrine. After operation, the patient had visual loss, facial palsy, total ophthalmoplegia, severe proptosis and submandibular swelling. There were no evidences of eyeball perforation, retrobulbar hemorrhage, and direct nerve injury. Although the mechanism of nerve injury is not well explainable, we suggest lidocaine toxic reaction. To our knowledge, This is the first reported case in the literature. We report this case with available literature review.
Anesthesia ; Anesthesia, General ; Blindness* ; Cataract* ; Epinephrine ; Exophthalmos ; Facial Paralysis ; Humans ; Lidocaine* ; Male ; Ophthalmoplegia ; Phacoemulsification ; Retrobulbar Hemorrhage ; Vitrectomy

We reviewed eight solitary fibrous tumors occurring at sites other than pleura (three orbit, two retroperitoneum, one each hard palate, thyroid, and tongue) which shared the histologic and immunohistochemical features of solitary fibrous tumors of pleura. Six patients were women, and two were men, aged from 26 to 74 years. The tumors ranging from 1.5 to 19 cm in diameter presented as well-circumscribed, unencapsulated, soft to rubbery tissue masses. Histologically they were characterized by a proliferation of spindle or ovoid cells intervened by a dense bundles of collagen. A variety of growth patterns was identified but the so-called patternless pattern was the predominant one. One tumor exhibited highly cellular sarcomatous areas with extensive necrosis, which was diagnosed as malignant solitary fibrous tumor. Immunohistochemical studies showed that all of the tumors were strongly positive for both CD34 and vimentin, but negative for cytokeratin, S-100 protein, EMA, and desmin. One case examined ultrastructurally showed features of fibroblast. All but one showed no evidence of recurrence or metastasis over follow-up period of 14 to 32 months. We conclude that extrapleural solitary fibrous tumors represent a distinct mesenchymal tumor with variable histologic features and should be differentiated from other spindle cell mesenchymal tumors.
Collagen ; Desmin ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Keratins ; Male ; Necrosis ; Neoplasm Metastasis ; Orbit ; Palate, Hard ; Pleura ; Recurrence ; S100 Proteins ; Solitary Fibrous Tumors* ; Thyroid Gland ; Vimentin

This article explores the medical system of the Koryo Dynasty period and its social characteristics. First, the structure of medical system and roles of medical institutions during the Koryo Dynasty period will be summarized. Then, the characteristics of the medical system will be identified through exploring the principles of its formation in a view of social recognition of medical care and a view of public policy. During the Koryo Dynasty period, medical experts were trained in national education institutions from the early days of Dynasty. After trained, they were appointed to the posts at government service with their medical profession. In the meantime, they sought ways to ascend their social position. Physicians of Oriental medicine were appointed to the posts at each local government and troops to take charge of medical treatments of the common people. Also, the state tried to assume the reins of medical system by actively taking part in circulation (collection and distribution) of herb. Taeuigam and Sangyakguk represent central medical institutions of the Koryo, taking charge of medical service for the aristocracy and the bureaucracy. The Common people were treated at DongSeoDaeBiWOn, JeWuiBo, HyeMinGuk, and YakJum in SeoKyung. However, activities of these institutions became less active around the days of military officials regime, as officers became negligent and financial base went broken. The roles of medical institutions of the Koryo government were not restricted to the treatment of diseases. Policies for the common people were constituted by two main policies, the policy for encouraging agriculture and the policy for giving relief to people. Medical institutions, with other social systems, had a social responsibility to support the governing system of the Koryo and maintain the stability of the society. In this aspect, medical institutions such as DongSeoDaeBiWon and JeWuiBo, and relief institutions such as UiChang, were all related and connected organically, and they were results of, and bases of the relief policy. However, medical system for the common people was made up first for practical needs and then improved successively. Allocation of medical experts and execution of relief work were carried out by each local government, except the case of serious disaster, which central government took part in. As the Koryo Dynasty went into its latter period, temporary institutions and one - time benefits replaced permanent institutions. These four characteristics described above were systemic characteristics of medical system during the Koryo Dynasty period.
English Abstract ; History of Medicine, Medieval ; Korea ; *Medicine ; Political Systems/*history

PURPOSE: This study was undertaken to evaluate the treatment outcome and side effects of accelerated radiotherapy (RT) using concomitant boost for stage III non-small cell lung cancer (NSCLC). METHODS: Between April 1991 and December 1994, 102 patients with stage III NSCLC who had the favorable prognostic factors by CALGB criteria, were treated with concomitant boost radiotherapy. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment was administered concomitantly during the last 2 weeks with a dose of 13 Gy in 10 fractions. The interfraction interval was at least 6 hours. The total tumor dose was 66-70 Gy, given over 6 weeks. RESULTS: With 30 months median follow-up period for survivors, median survival was 15 months with 2 and 3-year overall survival rates of 34% and 19%, respectively. Thirty patients (29%) who had achieved complete remission after RT showed significantly better 2-year survival rates than those without complete remission (58% vs 22%, p 0.001). Local failure and distant metastases as the first or only failure occurred in 40 (44%) and 13 (14%), respectively, and ultimate local and distant failure rates were 45% and 29%, respectively. Although Grade IV esophageal complication of T-E fistula was observed in one patient, most patients with pulmonary complication showed mild, transient radiation pneumonitis. CONCLUSION: This result suggests that the treatrnent of stage III NSCLC with concomitant boost RT may improve survival rates without enhanced radiation induced toxicity compared with conventional RT. Further investigation of dose escalation by conformal radiotherapy of combining chemotherapy and accelerated RT is warranted.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy ; Fistula ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiation Pneumonitis ; Radiotherapy* ; Radiotherapy, Conformal ; Small Cell Lung Carcinoma* ; Survival Rate ; Survivors ; Treatment Outcome