No abstract available.
Antibiotics, Antineoplastic/administration & dosage ; Bleomycin/*administration & dosage ; Child ; Dose-Response Relationship, Drug ; Humans ; Injections, Intralesional ; Lymphangioma/diagnosis/*therapy ; Magnetic Resonance Imaging ; Male ; Orbital Neoplasms/diagnosis/*therapy ; Pressure ; Tomography, X-Ray Computed

No abstract available.
Aged ; Biopsy ; Carcinoma, Squamous Cell/diagnosis/*etiology ; Dacryocystorhinostomy/*adverse effects ; Eye Neoplasms/diagnosis/*etiology ; Female ; Humans ; Lacrimal Apparatus/pathology/*surgery ; Lacrimal Apparatus Diseases/diagnosis/*etiology ; *Postoperative Complications ; Tomography, X-Ray Computed

BACKGROUND: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. MATERIALS AND METHODS: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. RESULTS: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis (8 cases) or chest tube drainage (10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases (42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, alpha-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1~4 (mean 1.78+/-1.00). Operating time was relatively short, about 55~140 mins (mean 102.8+/-30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3~42 days (mean 11.4+/-11.5) and 6~36 days (mean 12.9+/-8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3~6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. CONCLUSIONS: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.
Acinetobacter baumannii ; Causality ; Chest Tubes ; Cholecystectomy ; Drainage* ; Empyema* ; Enterococcus ; Fever ; Hemothorax ; Humans ; Length of Stay ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Recurrence ; Ribs* ; Streptococcus ; Thorax ; Tuberculosis, Pleural

PURPOSE: Primary localized amyloidosis is a disease characterized by the deposition of abnormal protein fibrils in a specific tissue without systemic involvement. We report a rare case of primary amyloidosis involving the extraocular muscle.CASE SUMMARY: A 51-year-old female visited our clinic due to diplopia. There was a 3 mm exophthalmos and restricted ocular motility in infraduction. Right hypertropia with 25 prism diopters was observed in the primary position. Orbital imaging scans showed fusiform enlargement of the inferior and medial rectus muscles with significant contrast enhancement in the right eye. A calcified nodule embedded in the medial rectus muscle was observed. Empirical steroid pulse therapy was conducted, but the patient showed little response. Subsequently, an incisional biopsy of inferior rectus muscle was performed. A histopathological examination showed amyloid deposits in hematoxylin and eosin staining, and a positive birefringence in Congo-red staining under polarized light, confirming amyloidosis. A systemic work up showed no evidence of systemic amyloidosis besides increased levels of rheumatoid factor. CONCLUSIONS When infiltrative myopathy of the extraocular muscle is suspected in a patient with exophthalmos and enlargement of extraocular muscles, primary amyloidosis should be considered in the differential diagnosis.

PURPOSE: To investigate the clinical features of acute ophthalmoplegia associated with anti-GQ1b antibody in the Republic of Korea. METHODS: From January 2011 to July 2018, we retrospectively reviewed the medical records of all patients who tested positive for anti-GQ1b antibody, and who had been concurrently diagnosed with acute ophthalmoplegia at a tertiary hospital in the Republic of Korea. Ophthalmic and neurological features were carefully reviewed. Laboratory results including ganglioside antibody panels and treatment outcomes were analyzed. RESULTS: Thirty-three patients were enrolled in the study and 8 (24%) of them showed pure Miller-Fisher syndrome with all three cardinal symptoms of ophthalmoplegia, ataxia, and areflexia. One patient (3%) showed ophthalmoplegia, areflexia, and pharyngeal- cervical-brachial weakness without ataxia and 2 patients (6%) showed only ophthalmoplegia and pharyngeal-cervical- brachial weakness without ataxia and areflexia. Twenty-two patients (67%) showed only ophthalmoplegia without any other neurological symptom. Early immunosuppressant treatment was used to treat 17 patients, and observation only was conducted as the initial treatment for 16 patients (48.5%). Twenty-four patients (72.7%) showed improvement and 9 patients showed persistent strabismus and diplopia. The average duration until recovery was 2.52 ± 2.11 months. CONCLUSIONS The symptoms of acute ophthalmoplegia associated with anti-GQ1b antibody can manifest in various forms that overlap with clinical features of demyelinating neuropathy, so it is important to recognize such characteristics when treating acute ophthamoplegia.

PURPOSE: This study compared the patency of the splenic vessels between laparoscopic and open spleen and splenic vessel-preserving distal pancreatectomy. METHODS: We retrospectively reviewed a database of 137 patients who underwent laparoscopic (n = 91) or open (n = 46) spleen and splenic vessel-preserving distal pancreatectomy at a single institute from 2001 through 2015. Splenic vessel patency was assessed by abdominal computed tomography and classified into three grades according to the degree of stenosis. RESULTS: The splenic artery patency rate was similar in both groups (97.8 vs. 95.7%, P = 0.779). Also, the splenic vein patency rate was not significantly different between the 2 groups (74.7% vs. 82.6%, P = 0.521). Postoperative wound complication was significantly lower in the laparoscopic group (19.8% vs. 28.3%, P = 0.006), and hospital stay was significantly shorter in the laparoscopic group (7 days vs. 9 days, P = 0.001) than in the open group. Median follow-up periods were 22 months (3.7–96.2 months) and 31.7 months (4–104 months) in the laparoscopic and open groups, respectively. CONCLUSION: Laparoscopic distal pancreatectomy showed good splenic vessel patency as well as open distal pancreatectomy. For this reason, splenic vessel patency is not an obstacle in performing laparoscopic splenic vessel-preserving distal pancreatectomy.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Pancreatectomy ; Retrospective Studies ; Spleen ; Splenic Artery ; Splenic Vein ; Vascular Patency ; Wounds and Injuries

PURPOSE: To evaluate contrast enhancement patterns of nodular hepatocellular carcinomas (HCCs) on three-phasespiral CT. MATERIALS AND METHOD: A retrospective analysis of contrast enhancement patterns was performed in 48 patients with HCC. Three-phase dynamic CT images of hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained at 30, 65, and 360 seconds after the initiation of injection of contrast material, respectively. Iodized-oil CT was performed two weeks after angiography and infusion of iodized-oil. Masses were divided into three groups, according to size ; 1-20 mm (n=34), 21-40 mm (n=26), and over 40 mm (n=19). Contrast enhancement patterns of tumors compared with attenuation of surrounding liver parenchyma, were cheracterized asone of four types, as follows : high, iso, low, and mixed attenuation. RESULTS: Seventy-three of 79 HCC nodules detected on iodized-oil CT (92%) were detected on three-phase spiral CT. In the 1-20 mm group, masses showed high-attenuation in the arterial dominant phase(19/34, 55.9%), and iso-attenuation in the portal dominant phase(16/34, 47.1%) and delayed phase(18/34, 52.9%). In the 21-40mm group, masses showed high-attenuation in the arterial dominant phase(21/26, 80.8%), low-attenuation in the portal dominant phase(13/26, 50%) and delayed phase(21/26, 80.8%). In the over 40 mm group, the masses showed mixed-attenuation in the arterial dominantphase(9/19, 47.4 %), low-attenuation in the portal dominant phase(12/19, 63.2%), and delayed phase(16/19, 84.2%).The most common enhancement pattern was high(arterial dominant)-iso(portal dominant)-iso(delayed) in the 1-20 mmgroup (8/34, 23.5 %), high-low-low in the group 21-40mm (8/26, 30.8%), and mixed-low-low in the over 40mm group(5/19, 26.3%). CONCLUSION: Hepatocellular carcinomas showed variable enhancing patterns according to the size ofthe tumor on three-phase spiral CT. Understanding these enhancing characteristics of HCCs on three-phase spiral CT may be helpful in their diagnosis.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis ; Liver ; Retrospective Studies ; Tomography, Spiral Computed*

BACKGROUND: High-risk percutaneous coronary interventions (PCI) are associated with high complication rate, low procedural success rate and high restenosis rate, especially in diabetics. We sought to observe whether diabetes affects long-term clinical outcomes after Abciximab (ReoPro(R)) therapy in Korean patients undergoing high-risk PCI. METHODS: One hundred nineteen patients with 152 lesion sites were administered ReoPro(R) out of 2,231 patients who underwent PCI at Chonnam National University Hospital from Mar 1999 to Feb 2001. They were divided into two groups, 30 in diabetic group (Group I, 57.7+/-8.2 years, 22 male) and 89 in non-diabetic group (Group II, 59.6+/-10.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed. RESULTS: In clinical diagnosis the number of acute myocardial infarction was 25 in Group I (83.3%) and 76 in Group II (85.4%). As for risk factors and target lesion artery, ACC/AHA types, there were no differences between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%) and thrombus-containing lesion 28 (93.3%) and 88 (98.9%) in Group I and II respectively. Procedure was successful in 27 (90.0%) in Group I and 80 (89.9%) in Group II and there were no differences in bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularization or cardiac death were observed in Group I, but there were 8 cases of MACE in Group II during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) during 18.5+/-6.7 (5~28) months. The number of overall MACEs were 10 (3.3%) in Group I and 14 (15.7%) in Group II (p=0.038). CONCLUSION: ReoPro(R)used in high-risk PCI in diabetics was effective in early clinical outcome, but long-term clinical benefits were not warranted.
Arteries ; Blood Platelets* ; Death ; Diagnosis ; Follow-Up Studies ; Glycoproteins* ; Hemorrhage ; Hospitalization ; Humans ; Jeollanam-do ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Platelet Aggregation ; Risk Factors

BACKGROUND AND OBJECTIVES: Brachytherapy is a promising method in the prevention and treatment of coronary stent restenosis. We sought to observe the therapeutic effects of a radioactive balloon loaded with Holmium-166 (166Ho) in a porcine coronary stent restenosis model. Materials and Methods: A radioisotope of (166Ho) was coated on the balloon surface using a polyurethane coating (20 Gy in 0.5 mm depth). Stent overdilation injuries were performed in two coronary arteries in 8 pigs. Four weeks after the stent overdilation injury, radiation therapies were performed using a control balloon dilation in one coronary artery (Group I:n = 8) and a 166Ho-coated balloon in the other coronary artery in each pig (Group II:n = 8). Follow-up coronary angiogram and histopathologic assessment were performed at 4 weeks after the therepy was administered. RESULTS: Laboratory findings did not differ significantly between the pre-treatment baseline and the measurements taken after radiation. On quantitative coronary angiogram, the coronary artery diameters were not significantly different between the two groups before stenting or at 4 and 8 weeks after stenting. On histopathologic analysis, injury score, internal elastic lamina area and lumen area did not differ significantly between the two groups. The neointimal area was 1.78 +/- 0.11 mm2 in group I and 1.36 +/- 0.12 mm2 in group II (p=0.017), and the histopathologic area of stenosis was 35.1 +/- 1.6% in Group I, 27.6 +/- 1.9% in Group II (p=0.005). CONCLUSION: A treatment of beta-radiation in a stented porcine coronary artery using radioactive Ho-166 coated balloon inhibits stent restenosis without any side effects.
Brachytherapy ; Constriction, Pathologic ; Coronary Disease ; Coronary Restenosis ; Coronary Vessels ; Follow-Up Studies ; Hyperplasia* ; Polyurethanes ; Radiation Injuries ; Radioisotopes ; Stents* ; Swine

BACKGROUND: High-risk percutaneous coronary interventions (PCIs) are associated with a high complication rate, a low procedural success rate and a high restenosis rate, especially in diabetics. We sought to determine whether abciximab (ReoPro (R) ) therapy affects long-term clinical outcomes of Korean patients with diabetes undergoing high-risk PCI. METHODS: One hundred and nineteen patients with 152 lesion sites were administered ReoPro (R) among 2, 231 patients who underwent PCI at Chonnam National University Hospital from March 1999 to Feb 2001. These 119 patients were divided into two groups, 30 were allocated to a diabetic group (Group I, 57.7 +/- 8.2 years, 22 male), and 89 to a non-diabetic group (Group II, 59.6 +/- 10.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed. RESULTS: In terms of clinical diagnosis, the number of acute myocardial infarctions in Group I was 25 (83.3%) and 76 in Group II (85.4%). As for risk factors, target artery lesions, and ACC/AHA types, no differences were found between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%), and the number with a thrombus-containing lesion was 28 (93.3%) and 88 (98.9%) in Groups I and II, respectively. The procedure was successful in 27 (90.0%) in Group I, and in 80 (89.9%) in Group II, and no differences were evident between the two groups in terms of bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularization or cardiac death, were observed in Group I, but 8 cases of MACE occurred in Group II during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) over 18.5 +/- 6.7 (5-28) months. The number of overall MACEs was 10 (3.3%) in Group I and 14 (15.7%) in Group II (p=0.038). CONCLUSION: ReoPro (R) used in high-risk PCI in diabetics was effective in terms of early clinical outcomes, but its long-term clinical benefits were not proven.
*Angioplasty, Transluminal, Percutaneous Coronary ; Antibodies, Monoclonal/*therapeutic use ; Comparative Study ; Coronary Angiography ; Coronary Stenosis/*therapy ; Diabetes Mellitus/*complications/drug therapy/radiography ; Female ; Human ; Immunoglobulins, Fab/*therapeutic use ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors ; Risk Factors ; Safety ; Stents ; Treatment Outcome