No abstract available.

Primary role of ultrasound in patients with thyroid nodule is to determine the multiplicity and detect occult carcinoma. We analyzed US findings of 53 thyroid carcinomas with multiple nodular lesions from january 1988 to december 1991. The results were as follows: 1. 109 malignant nodules in 53 cases and 24 benign in 23 were comfirmed. 2. The nature of the masses were solid in 72 malignant nodules (74.2%), and complex in 25 (25.8%) of which 19 were predominantly solid. 3. The echo pattern of the solid and solid predominant masses were hypoechoic in 78 malignant nodules (80.4%), hyperechoic in 10 (10.3%), and isoechoic in 3 (9.3%) 4. Internal punctate calcifications within the masses were observed in 31 malignant nodules (31.9%). 5. Halo sign was present in 16 malignant nodules(16.5%). 6. The preoperative sonographic diagnosis of thyroid carcinoma was made in 39.4% of 53 cases with multiple nodules on US. In conclusion, the number, and halo formation of nodules were insignificant to differentiate the benign nodule from the malignant. The heterogeneous hypoechoic nodules with size greater than 4cm, multiple stippled calcifications, displacement of the trachea or other surrounding structures of combined lymph node enlargements seem to indicate the possibility of malignancy.
Diagnosis ; Goiter* ; Humans ; Lymph Nodes ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Trachea ; Ultrasonography

We compared the rate of continuous curvilinear capsulorhexis[CCC]con traction and degree of postoperative capsular fibrosis between patients with non-proliferative diabetic retinopathy and age-matched non-diabetic patients after phacoemulsification with posterior chamber acryl foldable intraocular lens implantation.Sixty-two eyes of 42 patients of non-proliferative diabetic retinopathy and 78 eyes of 55 patients of control group who underwent cataract surgery with acryl foldable intraocular lens were enrolled in this retrospective study.During follow up examination the rate of CCC contractions were evaluated by NIDEK EAS-1000 System and we measured the area of anterior capsular opening.The diabetic patients average percentage of anterior capsular shirinkage rate was higher than non-diabetic patient's. But no statistically significant difference was found between the two groups. In conclusion, small incision cataract surgery with acryl foldable intraocular lens implantation showed good results in diabetic patients.Further studies will be needed for better clinical safety and efficacy.
Cataract ; Diabetic Retinopathy ; Fibrosis ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Retrospective Studies ; Traction

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*

The high variability of measured olfactory thresholds in humans reflects very broad range of sensitivity within and among individuals. This can be derived from the strongly compressive nature of olfaction, which makes it relatively hard to compare the size of two stimuli in odor sensation. However, we know that some portion of the variation is the result of extrinsic factors e.g. the method used to measure the olfactory threshold. For this reason, in order to address the bias and reliability of a psycophysical method, we combined the use of the CCCRC (Connecticut Chemosensory Clinical Research Center) test with the step method in 40 normal Korean adults twice a week for the evaluation of threshold. The measured thresholds showed high test-retest reliability and the threshold estimates remained consistent during the testing without trial-biases. Based on the results, we can conclude that a combined test using the CCCRC test and step method can be used in the measurement of olfactory threshold in a clinical context.
Adult* ; Bias (Epidemiology) ; Humans ; Odors ; Sensation ; Smell

NK/T-cell lymphoma is rare type of lymphoproliferative disorder, but it is clinically aggressive with a poor prognosis. The World Health Organization (WHO) classified mature NK cell neoplasms into extranodal NK/T-cell lymphoma nasal type and aggressive NK cell leukemia. NK/T-cell lymphoma is characterized by a strong association with Epstein-Barr virus (EBV), and when it involved the skin, the lesions clinically appear as deep nodules, infiltrative plaques and ulcerative plaques. We herein report on a case of the nasal type of extranodal NK/T-cell lymphoma that showed the immunophenotype of CD20-, CD56+ and CD45RO+, and it was positive on in situ hybridization for EBV. Our case was characterized by the clinical resemblance with pyoderma gangrenosum and this malady generally displays chronic painful ulcer and necrotic lesions.
Chronic Pain ; Herpesvirus 4, Human ; In Situ Hybridization ; Killer Cells, Natural ; Leukemia ; Lymphoma ; Lymphoproliferative Disorders ; Prognosis ; Pyoderma ; Pyoderma Gangrenosum ; Skin ; Ulcer ; World Health Organization

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Refractive Errors ; Refractive Surgical Procedures ; Visual Acuity

Forty year old woman with dysphagia underwent surgical correction of complete vascular ring formed by right aortic arch, Kommerell's diverticulum and ligamentum arteriosum. Operation consisted of ligamentum division, reduction diverticuloplasty and posterior diverticulopexy via left posterolateral thoracotomy. Dysphagia was relieved postoperatively, and concentic narrowing of esophagus in the level of aortic arch disappeared on postoperative esophagography.
Aorta, Thoracic ; Deglutition Disorders ; Diverticulum* ; Esophagus ; Female ; Humans ; Thoracotomy