The vitreous changes in 183 eyes of 148 patients with vitreous floaters were evaluated biomicroscopically using the Goldmann fundus contact lenses. The cases with retinal detachment were excluded from this study. Vitreous degeneration was responsible in all eyes with vitreous floater, and posterior vitreous detachment(PVD) was found in 87% of the eyes. In those eyes the most common cause of opacity were prepapillary ring(139 eyes). There were no significant difference in prevalence rate between male and female or between right and left eye with PVD. However the incidence was increased at the age of 50 or more. A strong statistical relationship was present between early onset and male or myopic eyes with minus 3 diopters or more. The eyes with sudden onset of floaters were frequently associated with retinal breaks. The study revealed that the complications of PVD may be encountered: retinal breaks, vitreous hemorrhage, photopsia, and cystoid macular edema. The complications were common in male.
Contact Lenses ; Female ; Humans ; Incidence ; Macular Edema ; Male ; Prevalence ; Retinal Detachment ; Retinal Perforations ; Vitreous Hemorrhage

We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

BACKGROUND: The relationship between the anterior site of acute myocardial infarction(MI) and occurrence of stroke has become a recent subject of much debate in the relevant literature. The object of this study was to examine the incidence of ischemic stroke during the hospitalization after an acute MI and to identify predictors of MI-related stroke. METHOD: We performed retrospective analysis of 452 patients with acute MI admitted to department of Neurology or Cardiology from January 1990 to August 1997. Patients with a stroke during hospitalization after acute MI were recruited for this study. RESULT: Thirteen cases were recorded. Seventy-seven percent (10/13) of the strokes occurred within 4 days after onset of MI. Multivariate analysis identified the following as independent predictors of stroke : History of hypertension(OR. 2.6: CI, 1.1 to 5.9), previous stroke(OR, 22.3: CI, 5.9 to 84.9) and congestive heart failure (CHF)(OR, 15.4: CI, 2.2-108.6). Transthoracic echocardiography(TTE) was performed in 349/452(77%) during hospitalization. The incidence of left ventricular thrombosis(LVT) in patients with anterior MI who received thrombolytic and anticoagulant therapy was not significantly different from that in patients with anterior MI who didn't(2.6% vs 6.1%, p=0.265). Stroke developed in only one of these patients with LVT. Thrombolytic and anticoagulant therapy were more frequently used in patients without stroke compared with stroke.(p<0.05). CONCLUSION: The incidence of stroke after acute MI is 2.9% and more frequent within the 4 days after MI. History of hypertension, previous stroke and congestive heart failure (CHF) were the factors independently favoring the occurrence of stroke, but there is no relation between the occurrence of stroke and anterior site of MI. Although intravenous thrombolytics followed by full anticoagulation treatment appeared to provide protection against ischemic stroke, it has no effect in the incidence of left ventricular thrombi in this study.
Cardiology ; Heart Failure ; Hospitalization ; Humans ; Hypertension ; Incidence ; Multivariate Analysis ; Myocardial Infarction* ; Neurology ; Retrospective Studies ; Stroke*

BACKGROUND: Ambulatory surgery has become popular because patients believe it allows them greater control over their business and personal lives and because third party payers find it reduces cost. This study was designed to compare the characteristics of induction and recovery as well as the safety of propofol with those of midazolam used for intravenous anesthesia in outpatient cystoscopy. METHODS: 56 healthy consenting outpatients were randomly assigned to receive either bolus of propofol (2 mg/kg, n=29) or midazolam (0.1 mg/kg, n=27) for anesthesia in outpatients cystoscopic procedure. All patients also received bolus of fentanyl 1ug/kg before induction and N-M blocking agent was not injected for maintenance of spontaneous respiration. Mean arterial pressure, HR and SpO2 were recorded and induction time (time to spontaneous eye closure), recovery time (time to response, time to orientation, time to ambulation) and adverse effects were evaluated. RESULTS: The results were as follows; 1) Both propofol and midazolam produced smooth induction, but caused significant respiratory depression. 2) The time of induction and postoperative recovery (time to ambulation) was faster in propofol than in midazolam. 3) There were less postoperative side effects (nausea, vomiting, dizziness) in propofol than in midazolam. 4) There were more cardiovascular depression in propofol than in midazolam. CONCLUSION: These results suggest 1) that propofol has significant advantage over midazolam in outpatient surgery, where early ambulation and discharge is desirable and 2) that both propofol and midazolam should be administered by expert anesthesiologist only when ventilatory assistant device with oxygen is immediately available.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthesia, Intravenous ; Arterial Pressure ; Commerce ; Cystoscopy* ; Depression ; Early Ambulation ; Fentanyl ; Humans ; Insurance, Health, Reimbursement ; Midazolam* ; Outpatients* ; Oxygen ; Propofol* ; Respiration ; Respiratory Insufficiency ; Vomiting

This study was carried out to evaluate and investigate the clinical utility of the plastic nasolacrimal stents (Song's tube) without fluoroscopic guidance in treatment of the obstructed nasolacrimal duct. The anesthesia was performed with Tetra-caine contained epinephrine in the nasal mucosa, proparcaine in the conjunctival sac and 2% lidocaine for infratrochlear block. The plastic stent were placed in the lacrimal system with the head portion lying in the lacrimal sac and body in the nasolacrimal duct and projecting into the inferior meatus of the nasal cavity. Complete resolution of epiphora was accomplished in 92(97%) of the 95 eyes with mean follow up of 8.5 months (minimal 6 months, maximal 18 months), and there were no significant complications under this procedure. This noninvasive procedure was indicated the anatomic obstruction of the nasolacrimal system, especially obstruction was at the junction between the lacrimal sac and nasolacrimal duct or stenosis of the nasolacrimal duct, which can be the probing as possbile. The use of the plastic nasolacrimal stents without fluoroscopic guidance have many advantages, as follow; There are no surgical dacryocystorhinostomy procedure, simple surgical technique and short duration of procedure, no risk of exposure radiation, and no needs of fluoroscope instrument and radiologist. Although evaluation of a longer-term follow up will be needed to determine the effectiveness of this thechnique, the utility of the plastic nasolacrimal stents without fluoroscopic guidance seem to be of value in primary management of the obstructed nasolacrimal duct, prior to the dacryocystorhinostomy procedure in proper indication of the nasolacrimal duct obstruction.
Anesthesia ; Constriction, Pathologic ; Dacryocystorhinostomy ; Deception ; Epinephrine ; Follow-Up Studies ; Head ; Lacrimal Apparatus Diseases ; Lidocaine ; Nasal Cavity ; Nasal Mucosa ; Nasolacrimal Duct* ; Plastics ; Stents*

Mazabraud's syndrome is rare benign disease characterized by the association of intramuscular myxoma and fibrous dysplasia of bone. We present a case of multiple intramuscular myxomas of the right forearm with polyostotic fibrous dysplasia. X-rays suggested fibrous dysplasia of adjacent bones and CT scans showed two intramuscular cystic masses on the right forearm. 99mTc bone scintigraphy also showed a markedly increased uptake in the skull, both scapulas, both clavicles and both humeri. The masses were successfully removed. Fibrous dysplasia of the radius and myxoma were confirmed by pathologic study.
Clavicle ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic ; Forearm ; Myxoma ; Radionuclide Imaging ; Radius ; Scapula ; Skull ; Tomography, X-Ray Computed

Many drugs can result in a variety of pathologic reactions in the lung, especially the cytotoxic drugs. Amongcytotoxic drugs bleomycin is a prototype. Bleomycin-related pulmonary toxicity is usually known as dose-dependent and can be enhanced with concurrent oxygen therapy, irradiation, or other chemotherapeutic agents. The incidence of bleomycin-induced pulmonary toxicity has been reported as varying from 2 to 46%, and 1% of fatal lung disease. We describe the radiographic and HRCT findings of bleomycin-related pulmonary toxicity developed in two patients: one in ovarian teratocarcinoma, the other malignant lymphoma patient. Chest radiographs and HRCT of these patients showed ground-glass opacities, consolidation, linear and reticular opacities, and interlobular septal thickening. These abnormalities were bilateral, and symmetrical and were found predominantly in the area of mid-and lower-lung zone.
Bleomycin ; Humans ; Incidence ; Lung Diseases ; Lung* ; Lymphoma ; Oxygen ; Radiography, Thoracic ; Teratocarcinoma

This study was performed to evaluate the usefulness of dermatomal somatosensory evoked potentials(D-SSEP) and segrnental somatosensory evoked potentials(S-SSEP) for the diagnosis of lurnbosacral radiculopathy. D-SSEP and S-SSEP were recorded from 30 healthy controls and 16 patients with lumbosacral radiculopathy(LA radiculopathy: 10 cases, L5: 13 cases, SI: 4 cases) who was diagnosed by clinical findings CT and/or MRI. D-SSEP were abnormal in 40%, 30.7% and 25% of the patients with IA, L5 and Sl radiculopathy respectively and S-SSEP were abnormal in 20%, 38% and 50% of the patients with IA, L5 and Sl radiculopathy respectively. The proportion of abnormal findings in the' patients with L4, L5 and Sl radiculopathy was increased to 50%, 46. 1% and 50% respectively by administering both of D-SSEP and S-SSEP. In conclusion, D-SSEP and S-SSEP are simple and noninvasive test but insensitive studies for diagnosis of lumbosacral radiculopathy. The diagnostic sensitivity could be increased by usmg both of these two studies.
Diagnosis ; Evoked Potentials, Somatosensory* ; Humans ; Magnetic Resonance Imaging ; Radiculopathy*

This study was performed to evaluate the effects of acute withdrawal of antiepileptic drugs in epileptic patients during continuous BEG monitoring. One hundred sixty-five withdrawals in 134 patients who were candidates for epileptic surgery were included for this study. Clinical features and frequency of seizure were observed after drug withdrawal with daily monitoring of serum drug level. The phases after withdrawal of antiepileptics were divided into phase of therapeutic drug level, phase of falling drug level, and phase of subtherapeutic or undetectable(zero) drug level. There were significant increase in frequency of seizure and seizure of secondary generalization after acute withdrawal of antiepileptic drugs. Number of seizure during the period of drugs withdrawals was not correlated with onset age of epilepsy, duration of epilepsy, duration of medication, and number of administrated antiepiteptic drugs. The number of frequency of seizure before drug withdrawal was correlated with the number of frequency of withdrawal seizure. The number of seizure frequency after carbamazepine withdrawal was significantly higher during the phase of subtherapeutic or zero drug level, and not during phase of rapid falling antiepileptic drug level.
Age of Onset ; Anticonvulsants* ; Carbamazepine ; Epilepsy ; Generalization (Psychology) ; Humans ; Seizures*

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests