Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).
Aged ; Aging ; Delivery of Health Care ; Glaucoma* ; Homes for the Aged ; Humans ; Korea ; Male ; Manometry ; Mass Screening* ; Ophthalmology ; Ophthalmoscopy ; Outpatients* ; Referral and Consultation ; Risk Factors ; Seoul ; Vascular Diseases

Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).
Aged ; Aging ; Delivery of Health Care ; Glaucoma* ; Homes for the Aged ; Humans ; Korea ; Male ; Manometry ; Mass Screening* ; Ophthalmology ; Ophthalmoscopy ; Outpatients* ; Referral and Consultation ; Risk Factors ; Seoul ; Vascular Diseases

OBJECTIVE: The study of 467 cases of amniocentesis have been done at the department of Genetics, Taegu Cheil Hospital from Oct. 1997 to May 1999 for the purpose of analysis of abnormal karyotype according to the indication and age distribution, METHODS: We collected amniotic fluid using 22G spinal needle and measured amniotic alphafetoprotein and acetylcholine esterase in supematant and performed cytogenetic analysis. RESULTS: Positive Down screeing(positive triple test) was the most common indication of amniocentesis (61.5%) and abnormal karyotypes were 24 cases(5.1%) in 467 cases. Among 24 abnormal cases, 10 cases(2.1%) of 21 trisomy were observed. Abnormal karyotypes were most common in the group of abnormal ultrasonogram finding and the gmup of maternal age between 31 to 35 years old, which consists of 25% and 7.7% respectively. CONCLUSION: More attention for the abnormal karyotype should be paid to the group of abnormal ultrasonogram finding and the group of maternal age between 31 to 35 years old as well as above 35 years old.
Abnormal Karyotype ; Acetylcholine ; Adult ; Age Distribution ; Amniocentesis ; Amniotic Fluid ; Cytogenetic Analysis* ; Cytogenetics* ; Daegu ; Female ; Genetics ; Humans ; Karyotype ; Maternal Age ; Needles ; Trisomy ; Ultrasonography

PURPOSE: We evaluated the usefulness of quantitative spiral CT to predict postoperative lung function in patients undergoing pulmonary resection. MATERIALS AND METHODS: Fourteen patients in whom pneumonectomy or segmentectomy were performed underwent preoperative chest spiral CT and pulmonary function test(PFT). Six patients underwent postoperative follow-up PFT. Ten patients underwent preoperative radioisotope(RI) lung perfusion scan. Preoperative CT data were postprocessed with contiguous pixel method ranged from -9107HU to -500HU to quantify total functional lung volume(TFLV) and regional volume to be resected(RFLV). Postoperative lung function was predicted by following formula;Predicted postoperative PFT value=preoperative PFT x 1-RFLV/TFLV). CT predicted value was compared with postoperative measured PFT value and those value of RI perfusion scan. RESULTS: CT predicted values were very close to postoperative measured value and RI predicted value, and were correlated well with postoperative measured values (FVC: r=0.988, P<0.001 ;FEV1: r=0.994, P<0.001) and RI predicted values (FVC :r=0.976, P<0.001 ;FEVl: r=0.974, p<0.001). CONCLUSION: Quantitative spiral CT was useful to predict postoperative lung function and could be an effective alternative to RI perfusion scan.
Follow-Up Studies ; Humans ; Lung* ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Thorax ; Tomography, Spiral Computed*

PURPOSE: We applied spiral CT to evaluate the dynamic changes of regional ventilation of the lung in normal subjects and abnormal patients. MATERIALS AND METHODS: This study includes normal subjects (n:5) and patients with chronic obstructive pulmonary disease (n=4), small air-way disease (n=3), diffuse panbronchiolitis (n=4), and tracheobronchial tuberculosis (n=2). Time-continuous scan data at a fixed level during forced vital capacity maneuver (10--12 seconds) were obtained and images were reconstructed retrospectively by using 0.67 second scan data per image. The reconstructed images were displayed in a cine mode. Time-density curves were plotted and were correlated with clinical diagnosis. RESULTS: In normal subjects, mean attenuation difference between full inspiration and full expiration was 145. 8HU and mean time interval between 20% expiration and 80% expiration was 2.04 seconds. In chronic obstructive lung disease, mean attenuation difference between full inspiration and full expiration was 21.2HU and mean time interval between 20% expiration and 80% expiration was 3.63 seconds. In small air-way disease, mosaic-pattern hyperlucency and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 49.8HU and 167.0HU, respectively. In diffuse panbronchiolitis, centrilobular region and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 35.4HU and 79.3HU, respectively. CONCLUSION: Respiratory dynamic CT is an updated technique which enable imaging of the functional status of the lung parenchyma. It may be useful in differentiation and quantitation of variable obstructive lung diseases.
Diagnosis ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Tomography, Spiral Computed ; Tuberculosis ; Ventilation ; Vital Capacity

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

Suture microvascular anastomosis is time-consuming and tedious and demands long and continuous training. The Unilink instrument system is a fast and simple method to achieve high patency rates without long and continuous training in the anastomosis of small vessels. The author experimentally studied the carotid arteries and facial veins of 14 rabbits with an average weight of 1900 gm using the unilink apparatus. A total of 27 arterial and venous anastomoses were performed. We examined the postoperative patency at immediate, 2 weeks, and 8 weeks. The results were as followings; 1. All anastomosed vessels were fully patent just after operation and at 2 weeks(100%), but one of the arterial anastomosis was thrombotized at 8 weeks(90%) 2. The mean time for completion of the anastomosis were 8.5 minutes(range 6-15) in arteries and 6.2 minutes.(range 4-10) in veins. 3. The cases having partial obliterations were 3 cases(15%) under the operating microscope. 4. At the histological examination, the thickness of vessel wall was decreased due to moderate atrophy of the media and mild degree of nonspecific chronic inflammation was seen around the unilink apparatus. 5. A case of the arterial anastomosis was released with acting out at 15 minutes after operation, and a case of arterial anastomosis showed complete oblieration at postoperative 8 weeks. 6. The important factors in the technical problems were the proper selection of the ring size and optimal fitting between two rings. The Unilink method provides a very safe, fast, and simple way to perform microvascular anastomoses.
Acting Out ; Arteries ; Atrophy ; Carotid Arteries ; Inflammation ; Methods ; Rabbits ; Sutures ; Veins

BACKGROUND: The present study was aimed (1) to assess the effects of nitric oxide (NO) synthesis inhibitor on regional myocardial function and systemic and pulmonary hemodynamics; (2) to determine whether the blockade of the cyclo-oxygenase (COX) pathway modifies these effects on the variables, and (3) to investigate the mechanism of cardiac depression following NO synthesis inhibition in an open-chest canine model. METHODS: Twenty-five dogs of either sex were acutely instrumented under 1.6% ethrane anesthesia to measure aortic, pulmonary arterial and left ventricular pressure, pulmonary (cardiac output) and left circumflex coronary flow, and subendocardial segment length. NG-nitro-L-arginine methyl ester (L- NAME) at doses of 0.3, 1.0, 3.0, or 10.0 mg/kg i.v. was administered alone (control dogs, n = 10) or in the presence of COX inhibitor, indomethacin (10 mg/kg i.v., n = 10). Seven dogs (n = 7) received phenylephrine at doses of 0.1, 0.3, 1.0, or 3.0 microgram/kg/min i.v. to compare its hemodynamic effects with those of L-NAME. The preload recruitable stroke work slope (Mw) and percent systolic shortening (%SS) as an index of regional myocardial contractility, and the maximum segment lengthening rate (dL/dt max) and percent post-systolic shortening (%PSS) as an index of regional diastolic function, were evaluated. RESULTS: L-NAME dose-dependantly attenuated both regional systolic (Mw and %SS) and diastolic functions (dL/dt max and %PSS), whereas it caused an increase of coronary flow. L-NAME dose- dependently increased systemic blood pressure and vascular resistance as well as pulmonary arterial pressure and vascular resistance. L-NAME also reduced cardiac and stroke volume indices. Pretreatment with indomethacin did not affect the regional myocardial and systemic hemodynamic responses to L-NAME, but did blunt the coronary flow and pulmonary pressure responses. The magnitude of decreases in cardiac and stroke volume indices and Mw was greater with L-NAME than with phenylephrine (P <0.05), despite the comparable blood pressure increases. CONCLUSIONS:These results suggest (1) that NO plays a significant role in cardiac function as well as in systemic and pulmonary but not coronary, vasomotor activities, and (2) that COX products are involved in pulmonary hemodynamic responses to NO synthesis inhibition. It is also suggested that the decline in cardiac output following the NO synthesis inhibition results from a direct myocardial depressant effect of the drug.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Depression ; Dogs* ; Enflurane ; Hemodynamics* ; Indomethacin ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Stroke ; Stroke Volume ; Vascular Resistance ; Ventricular Pressure

Endoscopic suspension of bladder neck by Stamey's procedure is a successful technique of correcting female stress urinary incontinence. We treated 27 patients complaining of urinary incontinence with Stamey operation from February, 1988 to March, 1994. The results was as follows l. Patients was distributed in age from 31 to 63 (mean; 48.8) years. All patients except one were multiparous, average 3.6(2-6)times of deliveries 2. Severities of incontinence were Grade I in 2 patients, Grade II in 20, Grade III in 5. 3. On preoperative lateral cystourethrogram, bladder base was descended about 1.1+/-0.57cm in resting, 2.63+/-1.24cm in straining from SCIPP(Sacrococcygeal-inferior point of pubic bone) line. Preoperative average PUVA(Posterior urethrovesical angle) was 142.2+/-53.27 degree, and average functional urethral length was 2.84+/-l.36cm. 4. Postoperative times of catheterization was 5.8 days, the amount of residual urine was lO5+/-10.3cc after removal of catheter. 5. Incontinence was completely disappeared in 24 patients(88.9%), but 3 patients were recurred due to break of suture material.
Catheterization ; Catheters ; Female ; Humans ; Neck ; Sutures ; Urinary Bladder ; Urinary Incontinence*