We assessed the degree of mydriasis induced by 1% tropicamide and 2.5% phenylephrine compared with that induced by 1% tropicamide and 10% phenylephrine in 100 patients with diabetes. Additionally we studied the difference of pupillary dilatation according to duration of dibetes, severity of retinopathy, and performance of photocoagulation. Maximum dilated pupillary diameter was 7.25+/-1.27mm in 2.5% phenylephrine group and 7.32+/-1.36mm in 10% phenylephrine group, respectively the difference in pupillary dilatation between two groups was not statistically significant. We advise the use of the 2.5% phenylephrine in patients with diabetes, who already exhibit a higher prevalence of vascular disease and autonomic nerve system dysfunction because 2.5% phenylephrine may produce a lower incidence of side effects than 10% concentration and have the same effect of pupil dilatation as 10% phenylephrine.
Autonomic Pathways ; Dilatation* ; Humans ; Incidence ; Light Coagulation ; Mydriasis ; Phenylephrine* ; Prevalence ; Pupil ; Tropicamide ; Vascular Diseases

No abstract available.
3,4-Dihydroxyphenylacetic Acid* ; Animals ; Brain* ; Diazepam* ; Rats*

No abstract available.
Acute Kidney Injury* ; Lymphoma*

PURPOSE: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis for early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10+LN). Breast cancer patients who had 10+LN clearly have a strikingly high risk of tumor recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients who had more than 10 positive axillary lymph nodes. METHODS: Of the 587 breast cancer patients who were operated on at Chungnam National University Hospital from February 1992 to November 1999, 31 cases (5.3%) showed involvement of more than 10 axillary lymph nodes. We evaluated the clinical courses of these patients and the differences in survival according to the clinical and pathologic vaiables. Survival was calculated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50+/-4 years. A mastectomy was done in 28 cases (90.3%), and a breast conserving operation was done in 3 cases (9.7%). The mean tumor size was 4.8+/-.5 cm. The mean number of removed axillary Lymph Nodes was 23.5+/-0.2 (range:10-52), and the mean number of positive axillary LNs was 20.0+/-10.1 (10-51). At a median follow-up of 30.5 months, 23 cases (74.2%) of recurrence were noted. Among these 23 cases (69.6%) showed distant metastases as the first recurrence. The 3-year and 5-year disease-free survivals were 28.6% and 22.9%, respectively. The 3-year and 5-year expected overall survivals were 53.7% and 41.8%, respectively. There were significantly more recurrences in patients who had given up taking their adjuvant chemotherapy than for those patients who had completed 6 cycles of FEC or MMM. Also, significant survival benefits were noted in those patients who were treated using a combination chemotherapy with taxane plus cisplatin after their tumor recurrence. CONCLUSION: Breast cancer patients with 10+LNs have a strikingly high risk of tumor recurrence. Six cycles of adjuvant chemotherapy with FEC or MMM was a controllable variable for lowering the risk of tumor recurrence. A combination chemotherapy with taxane and cisplatin was also a controllable variable for increasing survival after tumor recurrence.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Cisplatin ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Recurrence

Premacular hemorrhage (preretinal,subhyaloid, or sub-internal limiting membrane hemorrhage)impairs central vision abruptly and occurs in various underlying diseases. In cases of persistent hemorrhage, permanent impairment of vision may occur. Proposed therapeutic options for premacular hemorrhage consist of conservative treatment, laser photodisruption and early vitrectomy. Laser photodisruption may be performed in cases of persistent or slow-clearing hemorrhage, in patients with occupational need for prompt restoration of binocular vision or in patients with poor vision in their fellow eyes. The authors report 4 patients with premacular hemorrhage who were treated with Nd: YAG laser photodisruption with the review of the literatures.
Hemorrhage* ; Humans ; Lasers, Solid-State* ; Membranes ; Vision, Binocular ; Vitrectomy

No abstract available.
Gastroenteritis* ; Humans* ; Rotavirus*

Of the complictions of cataract extraction, it is well known that hemorrhage, infection and delayed wound healing are more frequent in diabetics than in nondiabetics. But if the extraction was performed after diabetes has adequately controlled for several weeks prior to operation, the visual results are almost as good in diabetics as in non-diabetics. However, with precautions for these complications, the aut hers carefully performed cataract extraction in two juvenile diabetics, whose blood sugar level had been poorly controlled in spited of diabetic diet and subcutaneous injection of the insulin before and after operation. The visual results were very good in spite of high blood sugar level before operation.
Blood Glucose ; Cataract Extraction ; Cataract* ; Diet, Diabetic ; Hemorrhage ; Injections, Subcutaneous ; Insulin ; Wound Healing

The ocular ischemic syndrome includes the ocular symptoms and sins secondary to severe carotid artery obstruction and is characterized by rubeosis iridis, anterior uveitis, retinal hemorrhage, cherry red spot, and neovascularization of the disc and/or retina. Recently, the authors have experienced a case of ocular ischemic syndrome in a 82 years old woman, who had neovascular glaucoma associated with ipsilateral internal carotid artery obstruction. Diagnosis was made by doppler ultrasonographic finding of atheroma of internal carotid artery.
Aged, 80 and over ; Carotid Arteries ; Carotid Artery, Internal* ; Diagnosis ; Female ; Glaucoma, Neovascular ; Humans ; Plaque, Atherosclerotic* ; Prunus ; Retina ; Retinal Hemorrhage ; Ultrasonography, Doppler* ; Uveitis, Anterior

There has been increased dialysis because of chronic renal failure, and also has been increased cataractous changes. We found 8 eyes(5 patients) who were under dialysis and also had cataractous changes. They received cataract operations. The results were obtained as follows: 1. Male to female ratio is 4:1 and the average age of cataract patients is 45 years old. 2. The cataractous changes after dialysis occurred within 1 year(except example 1). 3. We found that the cataracts developed from posterior subcapsule of lens(except example 1) and the corrected visual acuity at 2 months after surgery were over 0.5. 4. There were no serious problems after surgery(routine I.C.C.E.). 5. On blood chemistry, the average calcium level was 7.88mg% (hypocalcemic state), and we suggest that this condition may be related with cataractous changes.
Calcium ; Cataract* ; Chemistry ; Dialysis* ; Female ; Humans ; Kidney Failure, Chronic* ; Male ; Middle Aged ; Visual Acuity

The retrobulbar injection of anesthetic widely used in intraocular surgery will produce anterior displacement of eyeball and a rise in intraocular pressure that may be sufficient to compromise ocular perfusion. We investigated whether ocular hypotensive agent and Honan intraocular pressure reducer which reduced ocular tension before retrobulbar injection effected on lessening the risk of vascular compromise after retrobulbar injection. In the 1st group(15 eyes), no ocular pressure reducing procedure was applied, a mean intraocular pressure immediately after retrobulbar injection was 22.0+/-9.7mmHg. In the 2nd group (14 eyes), using ocular hypotonic agent before retrobulbar injection, a mean intraocular pressure was 13.8+/-4.4mmHg. In the 3rd group (20 eyes), using Honan intraocular pressure reducer, a mean intraocular pressure was 14.2+/-5.2mmHg. The difference in the rise of pressure attributable to retrobulbar injection of group 1 was statistically significant. An it was in only 2 eyes of gorup 1 that hypertension (IOP >35mmHg) which put the eye at risk for vascular occlusion after retrobulbar injection developed. The digital massage for 5 minute following retrobulbar injection produced no statistical difference in intraocular pressure before cataract surgery among all 3 groups. Using ocular hypotensive agents or Honan intraocular pressure reducer before retrobulbar injection may lessen the risk of vascular compromise immediately following retrobulbar injection. And preoperative digital massage for 5 minute may adequately decrease the intraocular pressure for intraocular surgery.
Anesthesia* ; Cataract ; Hypertension ; Intraocular Pressure* ; Massage ; Perfusion