No abstract available.
Amputation* ; Forearm* ; Upper Extremity*

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland

No abstract available.
Child* ; Humans ; Tuberculosis, Renal*

No abstract available.
Tissue Expansion Devices*

Purpose: To demonstrate the clinical features and natural course of chronic retinal detachment-associated neovascular glaucoma. Methods: Ten patients, diagnosed with chronic retinal detachment-associated neovascular glaucoma during 2007-2016 were retrospectively investigated. Besides chronic retinal detachment, no patients had any neovascular glaucoma-predisposing conditions, such as carotid artery disease. Retinal perfusion status was evaluated from the fundus fluorescein angiography images. Results: The mean age of patients was 57.5 years (range, 22-78 years). Complete retinal reattachment was achieved in three eyes, while partial or total chronic retinal detachment persisted in seven eyes. Wide-angle fundus fluorescein angiography revealed peripheral retinal capillary obstruction and severe nonperfusion. Neovascular glaucoma developed 213.4 months (range, 17-634 months) after retinal detachment. Three eyes received Ahmed valve implantation, while five eyes received intravitreal bevacizumab injection. Intraocular pressure was controlled in 10 eyes. Two eyes developed phthisis bulbi during follow-up. Conclusions In eyes with a chronic retinal detachment history, iris neovascularization and neovascular glaucoma can develop due to retinal capillary obstruction and chronic retinal ischemia, even after achieving retinal reattachment. We suggest regular follow-up examinations for patients with chronic retinal detachment, particularly for eyes with retinal nonperfusion, as detected on fundus fluorescein angiography.

OBJECTIVE: Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). METHODS: This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. RESULTS: Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group (31.2±30.3% vs. 55.1±37.5% vs. 54.0±36.9%, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. CONCLUSION: CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.
Cardiopulmonary Resuscitation* ; Energy Metabolism* ; Heart Rate ; Humans ; Manikins* ; Oxygen ; Students, Medical ; Thorax* ; Ventilation

Intraocular pressure(IOP) in children is often measured during anesthesia because it is difficult to obtain aedquate cooperation from and awake child. Evaluation of the impact of anesthetic drugs on IOP is imperative for accurate diagnosis and essential in avoiding untoward alterations in IOP during intraocular surgery. IT has been widely believed that IOP is reduced by inhalation anesthetic agenta, but ketamine has been reported to increase IOP have no effect on IOP and to decrease on IOP. WE have investigated the effect of ketamine only, ketamine and halothane, and pentothal sodium and halothane anesthesia on IOP in children. Thirty patients, ranging in age from 5 to 10 years and ASA physical status l to ll, scheduled for elective surgery, were the study group. No patients had glaucoma or corneal laceration. The patients were not premedicated. After instillation of local anesthetic solution into the conjunctival sac, control measurements of IOP were obtained in one eye with a pneumatic Applanation Tonometer(Alcon). The patients were then randomly divided into 4 groups. In group A(10), IOP measurements were recorded for 10 minutes at one minute interval after ketamine 2mg/kg i.v. In group B(10), anesthesia was induced with ketamine 2mg/kg i.v. and succinylcholine 1mg/kg was used to facilitate tracheal intubation. IOP was measured one minute after thiopental and after intubation. Anesthesia was maintained with haothane (1%)-N2O(2L/min)-O2(2L/min) and IOP were measured for 10 minutes at one minute intervals. In group C(10), succinylcholine 1mg/kg given one minute after thiopental 4~5 mg/kg, trachea was intubated following fasciculation and anesthesia was maintained with halothane (1%)-N2O(2L/min)-O2(2L/min). Thereafter IOP was measured for 10 minutes at one minute intervals. All IOP measurements were made by the same examiner using the same instrument. Pulse and blood pressure were simultaneously monitored. The results were as follows: 1) In group : The control value of IOP was 22.1+/-31 mmHg. Two minutes after ketamine 2mg/kg i.v., mild a increase (2~4mmHg) of IOP was observed and persisted thoroughout the 10 minutes but it was not statistically significant(p>0.05). 2) In group B: After ketamine and succinylcholine, IOP was moderately increased (29.8+/-3.86mmHg) over the control (24.0+/-4.09mmHg). AFter intubation, IOP was markedly increased (32.0+/-4.04mmHg) (p<0.05). Apparently, the elevation in IOP after intubation became reverted and stabilized in 6 minutes to normal or below control level under halothane anesthesia. 3) In group C: The control value of IOP was 20.7+/-1.11mmHg. It showed that thiopental by itself caused a significant decreased in IOP (17.4+/-2.87mmHg) (p<0.05). As in B group, IOP increased after succinylcholine(23.0+/-3.87 mmHg) and intubation(29.4+/-3.69mmHg)(p<0.05). Elevated IOP lowered and stabilized in 4 minutes after halothane anesthesia.
Anesthesia ; Anesthetics ; Blood Pressure ; Child* ; Diagnosis ; Fasciculation ; Glaucoma ; Halothane ; Humans ; Inhalation ; Intraocular Pressure* ; Intubation ; Ketamine* ; Lacerations ; Sodium ; Succinylcholine ; Thiopental ; Trachea

No abstract available.
Male ; Penis* ; Replantation*

PURPOSE: To report the clinical manifestations of patients with ocular tilt reaction (OTR) and the differential point from other disorders with abnormal head posture. METHODS: The clinical manifestations of four patients who complained of abnormal head posture and diplopia and who were diagnosed to have OTR from January, 2001 to January, 2002 were investigated. The diagnoses were made with alternate cover test, duction and version test, Lancaster test, Bielschowsky head tilt test, fundus photography, and brain MRI. RESULTS: All the four patients showed ipsilateral head tilt, ocular torsion, and vertical deviation. Type of their OTR was tonic OTR. Subjective tilting of visual vertical was observed in one patient. Only with the 3-step test, OTR could be misdiagnosed as an extraocular muscle palsy. The most important sign in differentiation from other disorders of abnormal head posture was ocular torsion. Duction and version examination and tilt of subjective visual vertical were also helpful for the differentiation. CONCLUSIONS: OTR should be considered in patients with ocular torsion, vertical deviation and ipsilateral head tilt. In patients with diplopia and head tilt, examination of ocular torsion should be performed with the 3-step test in order not to make a misdiagnosis of extraocular muscle palsy.
Brain ; Diagnosis ; Diagnostic Errors ; Diplopia ; Head ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Photography ; Posture

No abstract available.
Carbon*