Measuring the intraocular pressure is necessary for diagnosis, treatment and evaluation of prognosis in all glaucoma suspect cases. Since visual field analysis of a newborn infant is impossible, the diagnosis of congenital glaucoma depends exclusively on the value of intraocular pressure. The normal values of intraocular pressure in newborn infants and children are variable according to many authors. Until 1970, the average of infants' intraocular pressure was reported to be equal to or somewhat higher than that of adults. On the other hand, it has been generally believed to be definitely lower than that of adults since 1970. Precise measurement of intraocular pressure in infants is difficult and the value varies according to many factors such as general anesthesia, anesthetics used, depth of anesthesia and types of apparatus used. We studied the value of intraocular pressure of infants under 120 hours of age. After mummifying the infant, topical anestheics was instilled and the lids were opened with an infant size eye speculum and intraocular pressure was measured using a Perkin's hand-held applanation tonometer. The results were as follows: The mean value of the intraocular pressure for the right eye was 10.27 +/- 2.01mmHg and 10.25 +/- 1.80mmHg for the left eye. The range of the intraocular pressure was 6.5~6mmHg for the right eye and 6.6~6mmHg for the left eye.
Adult ; Anesthesia ; Anesthesia, General ; Anesthetics ; Child ; Diagnosis ; Glaucoma ; Hand ; Humans ; Infant ; Infant, Newborn* ; Intraocular Pressure* ; Prognosis ; Reference Values ; Surgical Instruments ; Visual Fields

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

No abstract available.
Hernia*

BACKGROUND: Acute appendicitis is very not uncommon disease and has many difficulties in the diagnosis of disease. So we should evaluate the significance of diagnosis by "MANTRELS" score which is very simple and easily accessible tools in patients of right lower quadrant abdominal pain. METHODS: We studied 164 patients initially complainted of right lower quadrant abdominal pain from Jan 1 to Jun 30. 1997 in emergency department of Yeungnam university hospital. At first, "MANTRELS" scores was calculated and we evaluated the final diagnosis, surgically operated or not, transferred or not, etc, retrospectively. Next, two groups were divided each that group A was surgically operated, group B was not surgically operated. And then the statistical significance and accuracy rate according to scores and cut-off values in each groups were evaluated. RESULTS: All 164 patients was admitted in emergency department of Yeungnam University hospital and male to female ratio was 1:0.98, mean ages was 35.3 years old. The incidences according to each items of "MANTRELS" were as follows; most in Tenderness and Shift to left, Migration of pain in group A and most in Tenderness and Anorexia. Nausea in group B. As the results according to each scores in both group, score 8; 25 cases, score 7; 14 cases in group B were showed and the correlation coefficients was 0.979. And as the results according to cut-off value in both groups. it's sensitivity and negative predictability. false negative, positive joint probability were decreased and others were increased as the cut-off values, respectively. The diagnostic weight was most highest(75.0%) when the cut-off value was 7. CONCLUSION: The authors would authorize that "MANTRELS" score is very simple scoring system and have diagnostic values in differentiating between acute appendicitis and other diseases complaining of right lower quadrant abdominal pain.
Abdominal Pain ; Anorexia ; Appendicitis* ; Diagnosis* ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Joints ; Male ; Nausea ; Retrospective Studies

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

No abstract available.
Anaphylaxis* ; Histamine Release* ; Histamine* ; Mast Cells*

Fluorescein angiography has become an indispensable ophthalmic diagnostic tool for detecting retinal and optic nerve pathology. The oral angiography is safer than intravenous angiography and is practical when intravenous administration is difficult. Since the resolution is somewhat inferior to that of intravenous fluorescein angiography, the use of oral fluorescein angiography was limited to the observation of dye leakage and pooling in late phase. We analyzed the sequence of fundus fluorescence following oral administration of the fluorescein dye in 34 subjects. Serial fundus photographs were taken at interval of 30 to 60 seconds for the first 15 minutes, and for the remaining 60 minutes, at interval of 5 to 15 minutes. Optic disc appeared first(6.6 minutes) followed by major vessels on and adjacent to the disc(7.4 minutes), choroidal fluorescence(9.0 minutes) and all the fundus structures(9.8 minutes). The peak fluorescence was detected about 25 minutes after dye ingestion. Sufficient fluorescence was obtained in all the cases without major complications and in the phase of maximal fluorescence, all the fundus structures were clearly visualized. In conclusion, oral fluorescein angiography can be a possible alternative to intravenous fluorescein angiography in whom, intravenous injection is unsuitable.
Administration, Intravenous ; Administration, Oral ; Angiography ; Choroid ; Eating ; Fluorescein Angiography* ; Fluorescein* ; Fluorescence ; Injections, Intravenous ; Optic Nerve ; Pathology ; Retinaldehyde

A K+-channel blocker, 4-aminopyridine(4-AP) increases neurotransmitter release from motor nerve terminals and has been shown to restore neuromuscular transmission in the myasthenic syndrome. It has been reported that the intravenous injection of 4-AP in the myasthenic patients caused many central adverse effects including anxiety and restlessness, but did not affect the blood pressure. The aim of this study was to observe the effect of intracerebroventricularly administered 4-AP on the blood pressure and to elucidate the mechanism of the action in urethane-anesthetized rabbits. Intracerebroventricular(icv) 4-AP produced pressor effects in a dose-dependent fashion, but intravenous(iv) 4-AP of the same dose did not altered the blood pressure. Tetraethylammonium, a K+-channel blocker which differs from 4-AP structurally, had little effect on the blood pressure, but 3,4-diaminopyridine, another derivative of the aminopyridine, produced pressor effect similar to 4-AP. The pressor effect of icv 4-AP was not affected by the treatment with iv phenoxybenzamine and chlorisondamine, and in bilateral adrenalectomized rabbits. These results suggest that the 4-AP pressor effect is not related to the periphral sympathetic nerve nor adrenal gland. The pretreatment with icv phentolamine and prazosin did not altered the 4-AP pressor. However, the icv 4-AP pressor effect was significantly attenuated by the treatment with icv yohimbine, and significantly potentiated by the treatment with icv clonidine. The treatment with icv diltiazem markedly inhibited the icv 4-AP pressor effect. It is concluded that 4-AP-sensitive K+-channels in rabbit brain might play a role in the regulation of blood pressure and that the 4-AP pressor effect is closely related to the central alpha2-adrenoceptors and L-type calcium channels.
4-Aminopyridine* ; Adrenal Glands ; Anxiety ; Arterial Pressure* ; Blood Pressure ; Brain ; Calcium Channels, L-Type ; Chlorisondamine ; Clonidine ; Diltiazem ; Humans ; Injections, Intravenous ; Neurotransmitter Agents ; Phenoxybenzamine ; Phentolamine ; Prazosin ; Psychomotor Agitation ; Rabbits ; Tetraethylammonium ; Yohimbine

Hospital information system has been widely used and increased recently for a variety of many aspects. And Order-Communication System(OCS), as like as hospital information system, has been used in many medical care facilities, which is simple and easily accessible, useful system. Also then the use of OCS in emergency care center in YUMC has been introduced sine 1996. 10, above 70% of availability is notice at present and increasing in the use rate, is considered that is very simple and accurate, time-saving, widely applicable system. So authors say that, after the use of OCS in emergency care center, interhospital exchange of the patient's information and also accomplishment of EMSS can be possible.

BACKGROUND: In some studies, 5 microgram/kg clonidine premedication was claimed to enhance the pressor effects of ephedrine in anesthetized patients. We studied hemodynamic responses to intravenous responses, themselves responses to intravenous ephedrine in patients who received clonidine 3 microgram/kg. METHODS: 40 ASA pysical status I or II patients were randomly assigned to either the clonidine group (n = 20), receiving oral clonidine 3 microgram/kg 90 min before general anesthesia, or the control group (n = 20), receiving no clonidine. Hemodynamic measurements were made at one-minute intervals for ten minutes after ephedrine 0.1 mg/kg was injected as a bolus. RESULTS: The magnitude of maximal systolic blood pressure increases in the clonidine group (13.2+/-9.3%) was no different in the control group (12.4+/-12.3%). There were no difference in the pressor effect and duration of response of ephedrine in both groups. CONCLUSIONS: The pressor effect of ephedrine is not enhanced in patients given 3 microgram/kg clonidine premedication during general anesthesia.
Anesthesia, General ; Blood Pressure ; Clonidine* ; Ephedrine* ; Hemodynamics ; Humans ; Premedication*